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Medicaid

LIS

New to MedicareThere is an Order of Operations for Enrollment Periods, just like Math has an Order of Operations. When we are trying to decide which Enrollment Period to you, we must keep the Order of Operations in mind.

  1. Initial Enrollment Period - IEP/ICEP/IEP2

  2. MA-OEP

  3. SEP

  4. AEP

  5. OEP-I

When trying to decide which Enrollment Period to use, go in order of 1-5. If IEP is available, then use that. If an SEP and MA-OEP are both available, then use MA-OEP because it comes first in the Order of Operations. If AEP and an SEP are both available, then use the SEP because it comes first in the Order of Operations.

Either check the list above, or create a phrase for yourself to remember the Order of Operations, like Please Excuse My Dear Aunt Sally for the Math Order of Operations.

Example:

I Must Stay Available Online.

...

Medicaid

LIS

IEP/ICEP/IEP2

Loss of Employer Coverage

Moving

Disabled - Turning 65

Delayed Part B - Already has Part A

Disaster SEP

Chronic Special Needs Plans

5-Star Plans

...

SEP Questions to ask, when digging for an SEP

  1. Have you recently moved, or will you be moving within the next month?  

    1. If they have moved in the last 2 months or moving next month 

      1. Use the Move dates  

    2. If they moved more than 2 months ago and NEVER updated their address with the Social Security Administration 

      1. Use today’s date 

  2. Have you recently returned to the United States after living permanently outside of the U.S.? 

  3. Have you lost your Medicaid eligibility in the past three months? 

  4. Do you get extra help paying for Medicare Prescription Drug coverage? 

  5. Do you no longer qualify for extra help paying for Medicare prescription drug coverage? 

  6. Have you recently lost your eligibility for a Special Needs Plan? 

  7. Have you recently left a PACE program? (Program for All-inclusive Care for the Elderly)

  8. Have you recently lost creditable prescription drug coverage involuntarily (as good as Medicare’s)? 

  9. Are you leaving or have you left employer or union coverage? 

  10. Do you belong to a State Pharmaceutical Assistance Program provided by your state? 

  11. Is there a 5-star plan in your area that you would like to enroll in? 

    1. Can only be used if enrolling into a 5-star plan and NOT currently in a 5-star plan.

  12. Do you live in, or have you recently moved out of, a Long-Term Care Facility (for example, a nursing home)?