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Choosing a Medicare Advantage plan can be tricky, especially when you have so many options. Depending on the type of plan in which you want to enroll, the time of year, and when you became eligible for Medicare Part A and Part B, your options may be limited. Keep reading to find out about the rules for Medicare enrollment periods.
New to Medicare?
If you recently became eligible for Medicare, through age or disability, you generally have the option to apply for coverage in a Medicare Advantage plan close to the date when your Medicare Part A and Part B coverage starts.
Your Medicare Advantage plan cannot start before both your Part A and Part B coverage begins. However, you generally have a period of seven months to apply for coverage in a Medicare Advantage plan.
This means you can apply for coverage in a Medicare Advantage plan three months before, the month of, or within three months after your Medicare Part A and Part B coverage starts. You must be enrolled in Medicare Part A and in Medicare Part B. This period is known as the Initial Coverage Election Period (ICEP).
Already enrolled in Medicare?
If you did not recently become eligible for Medicare, your enrollment options are different and may be limited to certain times during the year.
During this time, you may change or enroll in a Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD), or Prescription Drug Plan (PDP), or return to Original Medicare. Changes you make during this period will take effect on January 1 of the following year.
If you enrolled in a Medicare Advantage (MA) or Medicare Advantage Prescription Drug (MAPD) plan, you may switch plans or return to Original Medicare during this time. You can change plans only one time during this enrollment period.
During this time you cannot change your Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD), or Prescription Drug Plan (PDP) unless a special situation comes up which may allow you to qualify for a Special Enrollment Period (SEP).
In certain situations, you may be able to join, switch, or leave a Medicare Advantage (MA) plan, Medicare Advantage Prescription Drug (MAPD) plan, or a Prescription Drug Plan (PDP) during a Special Enrollment Period (SEP).
Some examples of special enrollment situations are:
Within ten (10) calendar days of receiving a member’s request to disenroll, CarePlus will acknowledge the request in writing and include the effective date of disenrollment with the plan. Beginning on the effective date of the member’s disenrollment, CarePlus will not cover any health care the individual receives. In addition, beginning on the effective date of the member’s disenrollment, the individual can see a healthcare provider through Original Medicare, unless the individual has enrolled in another Medicare Advantage plan. If the member’s doctor(s) needs to send claims to Medicare, the member may want to let the doctor(s) know that he/she just disenrolled from CarePlus and that it may take a few weeks for Medicare to update their records.
For additional information, please call CarePlus Member Services at 1-800-794-5907, (TTY: 711). From October 1 - March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.