One of the more common questions agents get asked from their Medicare clients is "what is the Medicare Part D late enrollment penalty?" It is fairly easy to explain that if a Medicare member spends more than 63 consecutive days without having Part D or creditable drug coverage, they will be required to pay a late enrollment penalty should they choose to enroll in a Part D plan in the future. The typical follow-up question is "will I have a late enrollment penalty?" This is also usually pretty easy to answer, assuming the agent asks the proper questions of the client and the client responds with accurate answers about prior coverage.
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Do you have clients whose Medicare Advantage Plans did not renew for 2013 and have yet to elect a new plan? They can still pick a new plan, and you can help them do it. Here are a few things to know in order to make sure your client has a smooth transition to their new Medicare Advantage Plan:
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As you know, selecting the correct election period for your client when facilitating an MAPD enrollment is an important step toward ensuring the beneficiary's enrollment form is processed for their proposed effective date. For 2013, there is a change in guidance of when to use IEP vs. ICEP. Let's take a closer look...
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A LIS qualification also triggers a SEP, and can be validated by member attestation, redetermination letter, or SSA award letter. The SEP is continuous, as long as the beneficiary is eligible for the Part D subsidy.
For those recently losing their status, the SEPs are as follows:
- Loss of subsidy at the end of a calendar year yields an election period of January 1 through March 31.
- January 1 may be used as a proposed effective date in this case if the enrollment is done prior to the end of the year.
- Loss of subsidy occurring at any other time runs similarly to the loss of dual status, beginning in the month in which the beneficiary is notified of the loss, and ending two months following the month of notification.
Many older Americans are heading to markets where their families are located, to be closer to grandchildren, and residing more in suburban communities than ever before. Any permanent move to a new service area generates an SEP for the Medicare beneficiary. If the client is wanting to enroll in a new plan prior to the move, they can complete their enrollment up to one month prior to moving, and designate an effective date up to three months from enrollment. However, the effective date cannot occur until after they have officially relocated to the new service area. If notification occurs before the move, then the SEP runs the month before, plus two months after the move. If notification is made after the move, the member then has two months from notification to make an election. If the member waits until their plan terms them, they then have two months from the plan term to make an election.