Situation
The shopper is already eligible for Medicare due to disability and is now turning 65. A new SEP is granted for these participants.
When to Enroll
Medicare Advantage/PDPs
Up to 3 months before the the first day of the month of their 65th birthday, the month of, and up to 3 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 their 65th birthday.*
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 initial 3 months to avoid a potential lapse in coverage.
Medigaps
Up to 3 months before the the first day of the month of their 65th birthday, the month of, and up to 6 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 of their 65th birthday.
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.
*The only exception is for customers with a birthday on the first day of the month in which case the effective date will be the first day of the preceding month.
Enrollment Reasons
Plan | Medicare Code/Reason | Dialer Code/Reason | Uses |
|---|
MAPD/PDP | IEP | MRD | May not be used again after the plan goes into effect |
MA-Only | OTH | MRD | May not be used again after the plan goes into effect |
Medigap | GI | GI | May be used multiple times until the enrollment window expires |
Additional Details
If the customer is already enrolled into a Medigap plan and switches to another Medigap with a new carrier or to a Medicare Advantage plan with a new carrier, they should be advised to call their current Medigap carrier to disenroll prior to the new plan’s effective date.