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
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.
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
Plan
Medicare Code/Reason
Dialer
Code/Reason
Uses
MAPD/PDP
IEP2
IEP2
May not be used again after the plan goes into effect
MA-Only
IEP2
IEP2
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.