Medicare Advantange Special Election Period (SEP)
January 12, 2015
|What is a Special Election Period (SEP)?
Special enrollment periods constitute periods outside of the usual IEP for Part D or AEP when an individual may elect a plan or change his or her current plan selection. As detailed below, there are various types of SEPs, including SEPs for dual eligibles, those whose current plan terminates, individuals changing residence and for beneficiaries meeting “exceptional conditions”.
Depending on the nature of the particular special election period, an individual may take a variety of actions, including:
Certain SEPs may be limited to an enrollment or disenrollment request. If the individual disenrolls from (or is disenrolled from) the PDP, the individual may subsequently enroll in a new Part D plan within the SEP time period. Once the individual’s enrollment in a new Part D plan becomes effective, the SEP ends even if the time frame for the SEP is still in effect. In other words, the SEP ends when the individual’s enrollment in a new Part D plan becomes effective or when the SEP time frame ends, whichever comes first, unless specified otherwise for an SEP.
The following are examples of questions that might be used to determine eligibility for an SEP:
|Additional SEPs include:
Ranking of Election Periods
Note: For a complete description of all Special Enrollment Periods, please review the Medicare Managed Care Manual, Chapter 2 – Medicare Advantage Enrollment and Disenrollment.
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