Enrollment dates

When can one change or enroll in a Medicare Advantage Plan, Medi Gap? Or Part D Rx?

Know for sure you’re eligible for a Medicare Advantage plan:

If you have Medicare Part A and Part B and you enroll during one of the enrollment periods, you’re eligible to join a Medicare Advantage plan. To be eligible for our plan, you must also reside in our service area. Generally, you are not eligible if you have End-Stage Renal Disease.

Know for sure if you’re eligible for Part D Prescriptions

Anyone who meets the following criteria is eligible for Medicare Prescription Drug coverage, and membership in our plan:

You are entitled to Medicare Part A or are enrolled in Part B.

Your permanent residence is within our service area.

You are not enrolled or do not plan to stay enrolled in another Medicare Prescription drug plan.

PLEASE NOTE:
Eligible individuals may only enroll in one Medicare prescription drug plan at a time and may not also be enrolled in a Medicare Advantage Plan (HMO, PPO) at the same time, unless they are a member of a Medicare Private-Fee-For-Service plan or are enrolled in an 1876 Cost Plan which does not have Part D coverage built in.

If you are enrolled in a Medicare Advantage HMO or PPO plan without prescription drug coverage, you’ll be disenrolled if you join a Medicare Part D prescription drug plan.

Here’s when you can join:

The Medicare program limits when and how often you can change the way you get Medicare, or switch health plans. If you switch from one plan to another plan this counts as making a change.

Initial Enrollment Period (IEP) Initial Coverage Election PeriodICEP

Available at specific times throughout the year for qualifiying individuals such as those who are aging into Medicare (3 months before you turn age 65 to 3 months after the month you turn age 65) or are newly eligible for Medicare Part B.

Annual Coordinated Election Period (AEP) Annual Election Period

From November 15 through December 31, anyone with Medicare will have an opportunity to switch from one way of receiving Medicare to another.

Open Enrollment Period (OEP)

From January 1 until March 31, Medicare Advantage eligible individuals may make one enrollment request.

However, you are limited in the type of plan you can join. You can’t join or leave Medicare prescription drug coverage at this time. For example, if you have a Medicare Advantage plan with prescription drug coverage, you can only choose to join another Medicare Advantage plan that offers Medicare prescription drug coverage, or choose to return to the Original Medicare Plan and join a Medicare Prescription Drug Plan. If you don’t have Medicare prescription drug coverage, you can’t use this chance to get it.

Aetna's Explanation

Special Enrollment Period (SEP) Special Election Period SEP View Attestation form in Blue Cross Part D Application

The following individuals qualify to enroll anytime throughout the year:

Moved from another state within 60 days

Dropped by an employer plan within 63 days

Turned 65 in the past 3 months (or will turn 65 in the next 3 months)

Newly eligible for Medicare Part B

Qualify for some assistance through Medicaid

Generally, you can’t make any other changes during the year unless you meet special exceptions, such as if you move or if you have Medicaid coverage. Under certain circumstances, you will be able to enroll in or change your Medicare Advantage plan outside of the standard enrollment periods. The length of your Special Enrollment Period (SEP) and when your new coverage starts will vary. The plan, and in some cases, the Center for Medicare and Medicaid Services (CMS), will determine whether an SEP applies to you. Later in the year, from November 15 to December 31, anyone with Medicare can switch their way of getting Medicare to another way for the following year.

Source

Rules on changing Medicare Advantage Plans
Medicare Website FAQ's

Blue Shield Medi Gap Guaranteed Guidelines

Blue Cross's Guide on Guaranteed Issue for Medi Gap Plans

Some of the print screens below may not be authorized for viewing by the public---so don't look. They are for Brokers Reference ONLY

secure horizons.com/

It doesn't say anything about if you cancel, they won't enroll you or if you have medical problems.

Member Rights
secure horizons.com/

Who is eligible for membership in Freedom Blue PPO?
Anyone who meets the following criteria is eligible for membership:
You maintain Part A (Hospital) of Medicare and continue to pay your Part B (Medical) premiums.
If you are not entitled to Medicare Part A benefits, you can purchase Part A through the Social Security Administration, and you must continue to pay the Part A premium to remain eligible for Freedom Blue.
Your permanent residence is within the geographic service area of Freedom Blue PPO.
You do not have kidney failure requiring dialysis or kidney transplantation (End-Stage Renal
Disease [ESRD]), unless you were enrolled as a member of any commercial BC Life & Health
health plan at the time of diagnosis with no lapse in coverage

Page 4 blue cross ca.com

If I need to disenroll what happens to my health care coverage?
Your membership in BC Life & Health?s Freedom Blue PPO is automatically renewed on a monthly basis. If you move out of California or decide that Freedom Blue is not right for you, you can disenroll from Freedom Blue. You can do this by writing to Freedom Blue, by going to your Social Security Office or by calling Medicare at 1-800-Medicare (1-800-633-4227).

For requests for disenrollment received by BC Life & Health Freedom Blue PPO by the last day of the month, your effective date of disenrollment will be the first day of the next month. For example, if we receive your disenrollment request on or before April 30th, your effective date of disenrollment will be May 1^st. You will receive Medicare benefits through the traditional method of fee-for-service, unless you have enrolled in another Medicare Advantage
HMO, or if you decide to take advantage of our Medicare Supplement Conversion Option, your coverage will convert to the plan you choose. In either case, you will not be penalized by Medicare in any way.

This might be in your Secure Horizons Agreement

I understand that enrollment in this plan is generally for the entire year. I may disenroll from Freedom Blue only at
certain times of the year, or under certain circumstances, by sending a written request to Freedom Blue Member
Services, the Social Security Office, the Railroad Retirement Board, or by calling 1-800-MEDICARE (TTY/TDD: 1-877-
486-2048). I understand that I must continue to receive all my health care from Freedom Blue providers until
BC Life & Health informs me of the effective date of disenrollment.

C. Effective date of coverage will normally be the first of the month following receipt of the completed application.
Please note: Individuals newly eligible for Medicare may apply up to three months prior to their eligibility date for
Medicare.Their enrollment date will be the same date as their Medicare effective date.
Individuals submitting an application during the Annual Open Enrollment in November must choose an enrollment effective date: December January bluecrossca.com

Guidance for Eligibility, Enrollment and Disenrollment procedures for Medicare Advantage (MA) plans, including MA-PD plans, is provided in Chapter 2 of the Medicare Managed Care Manual. Similar guidance for 1876 Cost plans is provided in Chapter 17, Subpart D of the same manual.
.. http://www.cms.hhs.gov

.. CMS provides instructions for enrolling Medicare beneficiaries in Medicare Prescription Drug Plans (PDPs) in the Agency?s PDP Guidance for Eligibility, Enrollment and Disenrollment.
.. http://www.cms.hhs.gov/

A set time that a beneficiary can change health plans or return to Original Medicare, such as: you move outside the service area, your Medicare+Choice organization violates its contract with you, the organization does not renew its contract with CMS, or other exceptional conditions determined by CMS. The Special Election Period is different from the Special Enrollment Period (SEP). (See Election Periods; Enrollment; Special Enrollment Period (SEP).)

A set time when you can sign up for Medicare Part B if you didn’t take Medicare Part B during the Initial Enrollment Period, because your or your spouse were working and had group health plan coverage through the employer or union. You can sign up at anytime you are covered under the group plan based on current employment status. The last eight months of the Special Enrollment Period starts the month after the employment ends or the group health coverage ends, whichever comes first. Medicare.gov/glossary