Compliance Update
Medicare Cards
Beginning in April 2018, the Centers for Medicare & Medicaid Services (CMS) will
start mailing Medicare ID cards with the new Medicare Beneficiary Identifier
(MBI). Cards will be sent to all people with Medicare in phases based on
geographic location.
CMS is removing Social Security Numbers (SSN) from all Medicare cards in an effort
to reduce identity fraud among seniors. The MBI will replace the SSN-based
Health Insurance Claim Number (HICN). The new Medicare Beneficiary Number
is unique to each person, and it will only be used for his/her Medicare coverage.
For more information on this change, including a sample of what the new Medicare ID card will look like, please click here.
Last month, CMS released a memo with their preliminary release schedule for new
Medicare ID cards. States are grouped into seven waves; so far, mail dates
are only identified for the first two waves. For more information on this release schedule, please click here.
New Enrollment Period
CMS has eliminated the existing MA disenrollment period (MADP) that currently
takes place from January 1st through February 14th of every year and, effective
for 2019, replaces it with a new Medicare Advantage open enrollment period
(OEP) that will take place from January 1st through March 31st annually.
The new OEP allows individuals enrolled in an MA plan to make a one-time
election to go to another MA plan or Original Medicare. Individuals using
the OEP to make a change may make a coordinating change to add or drop Part
D coverage. Beneficiaries will be allowed to make one MA plan change if needed,
including enrolling in a new plan, changing plans, or disenrolling from a
MA plan in favor of traditional Medicare.
Some of the reasons to take advantage of the open enrollment period include:
- The beneficiary didn’t realize that plan benefits or providers have changed
until after accessing medical care for the first time in the new plan
year
- The beneficiary decided that after trying a MA plan that it wasn’t right
for them or they would prefer a different MA plan.
- Due to change in health status or financial status between November and March,
a beneficiary could benefit financially from a switch.
- Since the AEP for Medicare is during a busy time filled with holidays and
bad weather, sometimes beneficiaries need a little more time to make
a thoughtful decision.
This chart contains an overview of initial, annual, and special enrollment possibilities
for beneficiaries. Information for carrier-specific enrollment codes can
be found on carrier broker portal sites.
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Jan |
Feb |
Mar |
Apr |
May |
Jun |
Jul |
Aug |
Sep |
Oct |
Nov |
Dec |
Initial Enrollment Period (IEP) |
Available throughout the year, IEP is the 7 month enrollment period
(determined by birth month) for beneficiaries getting Parts A
and B for the first time or the 3 month enrollment period (determined
by Part B date) for those that delayed purchasing Part B. |
General Enrollment Period (GEP) |
1/1 - 3/31 Enrollment for those who missed initial Enrollment
for Parts A and/or B. Plans start 7/1. |
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Pre-Annual Enrollment Period (Pre-AEP) |
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10/1 - 10/14 |
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Annual Enrollment Period (AEP) |
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10/15 - 12/7 |
Open Enrollment Period (OEP) |
1/1 - 3/31 Only 1 change is allowed for existing beneficiaries.
Plans start month after enrollment. |
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Special Election Period (SEP) |
Enrollment generally only allowed under certain circumstances. |
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