Did you know that there is a Special Election Period (SEP) for individuals whose plan or contract is terminated or non-renewed? This includes individuals impacted by service area reductions.
The End of Coverage (EOC) SEP can be used when a Medicare Advantage (MA) organization, Part D sponsor, and/or CMS terminates an individual's MA or Part D plan contract, discontinues the plan in the area the individual resides, or notifies an individual of an upcoming plan termination and/or service area reduction.
The eligibility period for this SEP begins on December 8 and ends on the last day of the following February.Any enrollment requests received from December 8 to December 31 will have an effective date of January 1; while enrollment requests received in January will have an effective date of February 1, and enrollment requests received in February will have an effective date of March 1.
What does this mean for you?
If your Medicare client received a service area reduction, non-renewed plan, and/or plan termination letter this year, there's still time to enroll them in an alternate MA or Part D option. When using this SEP to enroll a client, you do not need to provide a copy of the letter they received. You'll just need to follow the steps on the enrollment platform and use SEP code EOC or MYT (depending on the platform and the member's case). Please see an example below of how the codes display in ConnectureDRX.
- EOC Code –I lost my coverage because my plan no longer covers the area that I live or it ended its contract with Medicare.
- MYT Code –I lost my coverage because Medicare ended its contract with my plan. I received a letter from Medicare saying I can join another plan.
Don't miss this opportunity to enroll your Medicare clientele in the right plan for them before the year is over!