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Situation

The shopper is losing or leaving an employee group sponsored plan including COBRA.

When to Enroll

 Medicare Advantage/PDPs/Medigaps
  • Up to 3 months before the earliest possible effective date (the earliest possible effective date is the first of the month after group coverage ends), the month of, and up to 2 months after.

  • If the enrollment is completed during the initial 3 months of the enrollment window, the effective date will occur on the first day of the month after group coverage ends.

  • If the enrollment occurs anytime after the initial 3 months of the enrollment window, the effective date will occur on the first day of the month after the enrollment took place.

  • It is best to complete the enrollment during the first 3 months to avoid a potential lapse in coverage.

Enrollment Reasons

Plan

Code/Reason

Uses

MA/MAPD/PDP

LEC

May not be used again after the plan goes into effect

Medigap

GI

May not be used again after the plan goes into effect

 

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