When can I apply for Medicare Advantage Plans?

The Intial Coordinated Enrollment Period (IEP or ICEP) starts 3 months before the month you first acquire Medicare Parts A & B and ends 3 months after you have been enrolled in Medicare Parts A & 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 Advantage Plan during this IEP starting on March 1, 2010 and ending on September 30th, 2010.

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 Advantage 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.

The Open Enrollment Period (OEP) starts January 1st and ends March 31st of each year.  During the OEP, you can enter or exit any Medicare Advantage plan, so long as you meet the basic plan entry criteria and as long as you don't start or stop your Medicare Part D coverage.  The rules are a little confusing, but we specialize in Medicare and all of our licensed representatives are expert on this topic, so if in doubt, feel free to pick up the phone and give us a call.  More details are listed below:

• If you have Medicare Advantage Plan with drug coverage, you can do one of the following:
  • Switch to a different Medicare Advantage Plan with drug coverage.
  • Drop your Medicare Advantage Plan, go back to Original Medicare, and join a Medicare Prescription Drug Plan.

• If you have a Medicare Advantage Plan without drug coverage, you can do one of the following:
  • Switch to a different Medicare Advantage Plan that doesn’t have drug coverage.
  • Switch back to Original Medicare.

• If you have Original Medicare and a Medicare Prescription Drug Plan, you can join a Medicare Advantage Plan that includes drug coverage.

• If you have Original Medicare with no drug coverage, you can join a Medicare Advantage Plan that doesn’t include drug coverage.

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)  
7     MA Eligible (Open Enrollment Period, OEP, 1/1-3/31) 
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