Senior Educators: When can I apply for a Medicare Part D Prescription Drug Plan?

Medicare Part D Prescription Drug Plans generally run for an entire calendar year. You can only join or leave a Medicare Advantage plan during the Initial Enrollment Period, the Annual Election Period or a Special Election Period. You can learn about the details below by selecting the drop down questions, but as a rule of thumb, you can begin a Medicare Part D prescription drug plan when you are new to Medicare and you can switch your Medicare Advantage plan between November 15th and December 31 or if you qualify becuase of special circumstances (e.g., you move out of your Medicare Advantage coverage area).

What is the Initial Coordinated Enrollment Period (IEP or ICEP)?

The Intial Coordinated Enrollment Period (IEP or ICEP) starts 3 months before the month you first acquire Medicare Parts A and/or B and ends 3 months after you have been enrolled in Medicare Parts A and/or B. For example, if you turn 65 on June 15th of 2010, your Medicare Parts A & B would generally begin June 1 of 2010. You would be able to sign up for a Medicare Part D Prescription Drug Plan during this IEP starting on March 1, 2010 and ending on September 30th, 2010.

What is the Annual Election Period (AEP)?

The Annual Election Period (AEP) starts November 15th and ends December 31st of each year. During the AEP, you can enter or exit any Medicare Prescription Drug plan, so long as you meet the basic plan entry criteria. You only have 1 election during your AEP, so it makes sense to use a professional service like Senior Educators Insurance Services to make sure you make the right choice for you.

What are the Special Election Periods (SEPs)?

The Special Election Periods (SEPs) are additional elections that some Medicare beneficiaries are entitled to because of changing needs, unique or extraordinary circumstances. The most common SEPs are for individuals moving out of plan coverage area, loss of employer group coverage or change in plans.

The current complete list of SEPs is:
1     Enrolling into Part B After Delaying Enrollment Age-In
2   ICEP-Delay Part B
3     Age-In (OEPNEW for newly eligible - Beneficiary whose ICEP / IEP is no longer available)
4     Age-In (Eligible Prior to Age 65)
5     Enrolled into Part B during the Part B General Enrollment Period (GEP)
6     MA Eligible (Annual Election Period, AEP, 11/15-12/31)
8     Dual-Eligible (Full Benefit & Partial)
9     Dual-Eligible (Loss of Status)
10     LIS (Non-Medicaid & Maintaining LIS – Non-Medicaid LIS is 135% to 150% FPL)
11     Institutionalized
12     Change in Residence
13     Outside Plan’s Service Area Longer Than 6 Months
14     Involuntary Loss of Creditable Coverage
15     Loss of Employer Group Coverage (Group Retiree, COBRA, & Commercial Coverage)
16     Gain Employer Group Coverage
17     Non-Renewing (including Cost Plans)
18     Termination of Plan Contract
19     Retro Medicare Determination
20     Retro ESRD Determination
21     SPAP Members
22     Special Needs Status Change for Members of SNP
23     Severe or Disabling Chronic Condition
24     PACE
25     Individuals disenrolling from a cost plan and the cost plan’s optional supplemental Part D benefit
26     Erroneous Part D Enrollment or Non-Enrollment
27     Inadequate Notice of Creditable Coverage
28     Violation of Plan Contract Provision
29     CMS Sanction
30     Individuals enrolled based on misleading or incorrect information provided by plan employees, agents or brokers
31     First Time MA Enrollee (Age-In)
32     Individuals who drop Medigap and are in Trial period
33     Eligible for Other Creditable Coverage