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Special Election Periods Q and A

Special Election Periods Q and A

FromMedicare Nation


Special Election Periods Q and A

FromMedicare Nation

ratings:
Length:
22 minutes
Released:
Jul 29, 2016
Format:
Podcast episode

Description

Welcome Medicare Nation! We have a question today and I know many of you need this information!   MEDICARE SPECIAL ENROLLMENT PERIOD SHOW NOTES Here’s quick guide to when you can make changes to your Medicare Advantage Plan:   You can make your initial selection of a Medicare Advantage Plan when you enroll in Medicare at age 65. During the Annual Enrollment Period which is between October 15th through Dec 7th every year. You can dis-enroll from a Medicare Advantage Plan between January 1- Feb 14th, but you would have to go back on to Original Medicare because you cannot switch to another Medicare Advantage Plan at this time. You may have a “Special Election” that qualifies you to change your plan.   The Special Election Period that qualifies you to change your Medicare Advantage Plan, is what we want to focus on today.  There are certain circumstances which allow you to qualify for this option. If You Move If you move and your new residence is not in your plan service area. You would need to notify Medicare as soon as possible, because you have the rest of the current month you are moving and the following 2 full months as the Special Election Period.  If you move to a new address and your plan is still in your service area, but by moving you now have new options available to you that you didn’t previously have, then you would have a Special Election Period to change to one of the new option plans. Snowbirds that live in 2 locations, have to determine which of those residences is your primary residence. Where you vote and where you pay taxes are going to determine which is your primary residence. If you move out of the country for a period of time and now you are coming back to live in the US,  that will trigger a Special Election Period. If you are moving into a long term care facility or a Skilled Nursing Facility with round the clock skilled nursing care, you would have a Special Election Period when you move into the facility, while you are residing in the facility and when you move out of the facility.  Losing Coverage: If you leave your Employer's Insurance Plan, or union through retirement, turning 65, etc. If you had an involuntary loss of drug coverage that was as good or better than Medicare drug coverage(credible coverage), that triggers a SEP. Or if you have had drug coverage through a Medicare Cost Plan and you leave the Cost Plan. If you leave a PACE (Program All-Inclusive Care for the Elderly) Program. If you had Medicaid and lost eligibility because of income requirements.   When there are plan changes with Medicare Contracts: If your Medicare Advantage Plan was sanctioned by CMS, then you would be able to contact Medicare directly to request a Special Election Period  to choose another Medicare Advantage Plan. If Medicare terminated a contract with your Medicare Advantage Plan, that will trigger a Special Election Period and CMS will notify you.   Special Circumstances You qualify as a Medicare & Medicaid recipient, you may change Medicare Advantage Plans as often as you'd like! If you qualify for LIS (Limited Income Sources) you may get extra help with prescription drug coverage and a Special Election Period to enroll in a different Medicare Advantage Plan. During your Initial Enrollment Period for Medicare, you may have enrolled in a Medigap plan, and decided to change to a Medicare Advantage Plan during your first enrollment year. If you decide you want to change back to a Medicare Supplement Plan during your first year of coverage, you qualify. SNP Plan - for chronic conditions (Diabetes, Heart Disease, COP) - may change your current Medicare Advantage Plan to enroll in a SNP plan, or you may no longer qualify for a SNP, so you can choose another Medicare Advantage Plan. f an error was made by a federal employee when you signed up for Medicare, and you can prove it, you may be granted an SEP.   *****You cannot get an SEP because your Doctor left the network******** If you have a Medicare Suppleme
Released:
Jul 29, 2016
Format:
Podcast episode

Titles in the series (100)

How much would you pay out-of-pocket for a five day hospital stay on Medicare? The majority of people have no idea! The problem with Medicare is there is too much information. An overwhelming amount of information and not enough resources. Medicare Nation solves that problem by educating you on all things Medicare, because there are not enough resources out there! This podcast will educate you about the components of Medicare, the different categories of Medicare Plans and Medicare benefits. On other episodes I’ll interview expert guests in the health and wellness field, about diseases, Medicare issues and current changes to the Medicare program. Medicare Nation is dedicated to answering all your questions about Medicare. Expert information and insights regarding Medicare and you! Further information can be found on www.callsamm.com Give us feedback on Facebook! www.facebook.com/MedicareNation