Medicare Election Periods
Even outside of AEP, it is crucial that you know about each of the Medicare Election Periods, and to make sure you document them on your applications. This is a critical step to make sure your applications are processed correctly.
Annual Enrollment Period
This is the most common of all the Medicare Election Periods. This will run between October 15th and December 7th. All of your applications will have AEP documented if your client is making a change during this time. Also remember, during the Annual Enrollment Period, it is the last application placed that counts. If you are selling early in the season, make sure that you have closed that sale and nobody comes in behind you.
When Can You Start Marketing for AEP?
The marketing period for AEP starts on October 1st. Make sure all of your SOAs and all of your appointments are scheduled on dates after September 30th.
What is the Deadline to Certify for the Medicare Advantage Carriers?
Every carrier is a little different, so a good rule of thumb is to be certified by October 1st. If you need any assistance, visit Tidewater Management Group’s website for specifics as it pertains to the different carriers and what it takes to get certified.
Medicare Part A & Part B Sign Up Periods
When someone first becomes Medicare eligible, they have a 7 month window of opportunity to enroll. The customer has 3 months prior to their birth month, the actual birth month, and 3 months after their Medicare becomes effective to make a decision. So make sure your clients who age into Medicare, know about that 7 month window.
Special Election Periods
There are a lot of different options when it comes to special enrollment periods. Your clients can make changes to their plans when certain things come up in life, like if they move or their plan is not available in the area anymore. These circumstances are called Special Enrollment Periods (SEPs).
Natural Disaster SEP
In some years there are unfortunate events that cause enrollees difficulty in choosing a plan or making decisions during AEP. CMS can choose to permitted the opportunity to enroll, dis-enroll, or make a plan change to all of the victims in the affected areas.
In order for members to be considered “affected” victims of these disasters, they must reside or resided in an area at the start of the incident declared as emergency major disaster by Federal Emergency Management Agency (FEMA).
Change in Residency
You may have a client that has just moved to that specific service area, if that is the case, your client has what is called a Change in Residency.
If your client notifies the carrier before they move, their window to change starts the month before the month they move and continues for 2 months after. If they notify the carrier after they move, the window begins the month they tell the carrier, plus 2 more months.
Low Income Subsidy (LIS)
There are other Special Elections you may run into during AEP. You could have a client that is LIS or Low Income Subsidy. Those clients have a year round Election Period in which you can either write a 2017 application or a 2018 application.
Dual Eligible Special Needs Plans (D-SNP)
Some people who are eligible for both Medicare and Medicaid are called “dual eligibles". The D-SNP eligible client will also have a year round election period though they have to wait 30 days between changes. This client can either enroll for 2017 or 2018 effective and this is why putting the correct election period on the application is so important.
Chronic Condition Special Needs Plans (C-SNP)
You can also come across someone that is Dual Eligible during this time. The DSNP eligible client will also have a year round election period every 30 days. This client can either enroll for 2017 or 2018 effective and this is why putting the correct election period on the application is so important.
There are many other circumstances that allow special election periods. To read about each of these in more detail, visit Medicare.gov.