Molina: Special Enrollment Opportunities

You may have additional opportunities to enroll members for a January 1 effective date!

AEP has ended, but there are Special Enrollment Periods (SEPs) that may allow some beneficiaries to enroll in Medicare when AEP is over. Take a look at some of the possible opportunities over the next few weeks! One of the following Special Enrollment Periods may be available for your prospective members.

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Government Entity-Declared Disaster or Other Emergency

There's an SEP if a beneficiary resides in a geographical location for which a government entity has declared a disaster/emergency, and they come to you because they were not able to make an election during AEP due to the disaster/emergency.

• FEMA Disaster Declarations
• MMCM, Ch. 2, p. 46. 42 CFR 422.62(b)(18)(Rev.2)

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Open Enrollment Period for Institutionalized (OEPI) Individuals

If a beneficiary contacts you and requests an appointment because they just moved into, currently live in, or just moved out of an institution, there's an SEP for that.

• May join, switch or drop coverage while living in an institution and for two months after moving out
• MMCM, Ch. 2, p. 31. 30.3

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Change in Dual/LIS Status

An SEP exists for when a prospect had a recent change in their Medicaid, Medicare prescription drug coverage, or Extra Help.

• When they become eligible, lose eligibility, or the level of assistance they receive changes, there's a one-time SEP to disenroll from or switch for three months after being notified
• MMCM, Ch. 2, p. 43. 42 CFR 423.38(c)(9)

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MA Trial Period SEP

This SEP may be used when a prospect wants to use their “trial period” SEP and disenroll from their first MA plan.

• Beneficiaries who enrolled in an MA plan during their ICEP can switch or drop MA coverage during the first three months they have Medicare Parts A and B
• MMCM, Ch. 2, p. 49. 42 CFR 422.62(a)(3)

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Don't forget to enroll members based on their Initial Coverage Election Period (ICEP)!

• Each day approximately 11,000 Americans age into the U.S. Medicare system. They can enroll in a Medicare plan 3 months before and 3 months after their 65th birth month. That means thousands of potential members are poised for enrollment. Contact us for more information.

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There are many more SEPs that may work for beneficiaries!

Visit Medicare.gov to read about changes in residence, problems with current coverage, chances to get better coverage, Medicare contract changes, and

other qualifying SEPs.

For specific details, please visit the websites listed here.