Module 5

Module 5-Enrollment Guidance Medicare Advantage and Part D Plans_PY21 1. Module 5: Enrollment Guidance Medicare Advantage and Part D Plans 1.1 Enrollment Guidance Medicare Advantage and Part D Plans

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1.2 Navigation Instructions

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1.3 Terms and Conditions

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1.4 LEARNING OBJECTIVES

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1.5 Training Roadmap: Part 1

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1.6 Who is Eligible to Enroll and Basic Enrollment Rules

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1.7 Who is Eligible to Enroll in MA or Part D Plans?

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1.8 Who is Eligible to Enroll in MA or Part D Plans? Continued

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1.9 Enrollment Rules

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1.10 Enrollment Rules, continued

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1.11 Enrollment Periods: An Introduction

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1.12 Roadmap to Enrollment Periods

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1.13 Enrollment Periods -- Overview

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1.14 MA and Part D Enrollment Periods Brief Summary

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1.15 Enrollment Periods Initial Enrollment Periods

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1.16 Enrollment Periods MA Initial Coverage Election Period (ICEP)

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1.17 Enrollment Periods MA ICEP, continued

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1.18 Enrollment Periods- MA ICEP, Example

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1.19 Enrollment Periods Part D Initial Enrollment Period (IEP)

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1.20 Enrollment Periods - Part D Initial Enrollment Period (IEP), Example

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1.21 Enrollment Periods IEP and ICEP Occurring Together

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1.22 Enrollment Periods - Annual Election Period

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1.23 Enrollment Periods - Annual Election Period

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1.24 Enrollment Periods Annual Election Period, Example

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1.25 Enrollment Periods - Annual Election Period, Timeframe for Submitting Enrollment Forms

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1.26 Enrollment Periods - Annual Election Period, Timeframes for Submitting Enrollment Forms, continued

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1.27 Enrollment Periods MA Open Enrollment Period

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1.28 Enrollment Periods MA Open Enrollment Period (MA OEP)

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1.29 Enrollment Periods (MA OEP), Continued

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1.30 Enrollment Periods MA OEP, Limitations

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1.31 Enrollment Periods MA OEP- Newly Eligible MA Enrollees

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1.32 Enrollment Periods - MA OEP: Examples

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1.33 Enrollment Periods Special Election Periods (SEPs)

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1.34 Enrollment Periods - SEPs

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1.35 Enrollment Periods - SEPs, continued

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1.36 Enrollment Periods - SEPs, Limitations

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1.37 Typical SEPs -- Severe or Disabling Chronic Conditions

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1.38 Typical SEPs -- Severe or Disabling Chronic Conditions, Example

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1.39 Typical SEPs - Change of Residence

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1.40 Typical SEPs - Involuntary Loss of Creditable Drug Coverage

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1.41 Typical SEPs - Beneficiaries who are dual eligible or who have LIS eligibility

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1.42 Typical SEPs - Beneficiaries who are dual eligible or who have LIS eligibility, limitations for certain beneficiaries

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1.43 Typical SEPs - Change in Medicaid or LIS Status

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1.44 Other Common SEPs

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1.45 Typical SEPs – Enrollment in a 5-Star Plans

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1.46 Enrollment Periods Open Enrollment Period for Institutionalized Individuals

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1.47 MA Open Enrollment Period for Institutionalized (OEPI) Individuals/Part D SEP for Institutionalized Individuals

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1.48 Cost Plan Enrollment Periods

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1.49 Cost Plan Enrollment Periods

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1.50 Enrollment Requests

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1.51 Formats of Enrollment Requests

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1.52 MA Opt-in Enrollment Requests

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1.53 Formats of Enrollment Requests, Automatic/Passive Enrollment

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1.54 Formats of Enrollment Requests - Paper

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1.55 Formats of Enrollment Requests - Electronic Enrollment

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1.56 Formats of Enrollment Requests -Electronic Enrollment, Continued

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1.57 Formats of Enrollment Requests - Telephone

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1.58 Formats of Enrollment Requests - Telephone, Continued

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1.59 Who May Complete the Enrollment?

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1.60 Who May Complete the Enrollment? Continued

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1.61 Who May Complete the Enrollment? Marketing Representative Participation

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1.62 Beneficiary Acknowledgements and Enrollee Discrimination Prohibitions

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1.63 Beneficiary Acknowledgements when Enrolling

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1.64 Enrollment Discrimination Prohibitions

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1.65 Enrollment Discrimination Prohibitions and Exceptions, Continued

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1.66 Post-Enrollment Activities and Rules

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1.67 Post-Enrollment Request: Beneficiary Notifications Prior to Effective Date

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1.68 Post-Enrollment Request: Beneficiary Notifications Prior to Effective Date, Continued

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1.69 Post-Enrollment Request: Materials for the Beneficiary

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1.70 Post-Enrollment: When does coverage begin?

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1.71 Post-Enrollment: When does coverage begin?, Continued

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1.72 Disenrollment

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1.73 Disenrollment from MA, Part D or Cost Plans

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1.74 Voluntary Disenrollment from MA or Part D Plans

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1.75 Voluntary Disenrollment from MA or Part D Plans, Continued

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1.76 Voluntary Disenrollment from Cost Plans

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1.77 Who May Request Disenrollment

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1.78 Required Involuntary Disenrollment from MA or Part D Plans

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1.79 Required Involuntary Disenrollment from MA or Part D Plans, Continued

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1.80 Temporary Exception to Involuntary Disenrollment When an Enrollee Moves from the Service Area

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1.81 Required Involuntary Disenrollment from Cost and MSA Plans

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1.82 Optional Involuntary Disenrollment from MA, Part D or Cost Plans

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1.83 Optional Involuntary Disenrollment from MA, Part D or Cost Plans Failure to Pay Premium

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1.84 Optional Involuntary Disenrollment from MA, Part D or Cost Plans Failure to Pay Premium, Plan Policies

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1.85 Optional Involuntary Disenrollment from MA, Part D or Cost Plans Failure to Pay Premium, Enrollee Rights

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1.86 Additional information

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1.87 THANK YOU

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