Did I Miss It? Medicare AEP Enrollment Period / Deadline

When it comes to Medicare Part D prescription drug plans, annual enrollment periods are very important. Annual enrollment period happens each year and gives beneficiaries the opportunity to change their prescription drug plan provider from one company to another. There are no questions that are asked during this time nor do people need a specific reason to make this change. Those that want to change their insurance provider can do so during this time. Annual enrollment period for Medicare Part D beneficiaries started on October 15, 2012 and ends December 7, 2012 for the benefit year 2013.

I Missed It. Now What Do I Do?

There are some people that are interested in changing their part d provider and aren’t aware of their opportunity to. The annual enrollment period is something that has been heavily publicized and discussed but some people still don’t make the changes they want to make in the timeframe allotted. When this happens there are very few things that can be done.

When beneficiaries have a part D provider and changes aren’t made during AEP will continue with their current Medicare Part D provider. This is something that a lot of people don’t want to hear but it’s something that is true in most circumstances. Centers for Medicaid and Medicare Services have established specific rules that have to be observed when it comes to enrolling into different prescription drug plans and working with providers. There are specific times that people can enroll into different prescription drug plans without any questions being asked. AEP, annual enrollment period, is one of those times.

There are times that people will miss AEP and still need to enroll into a different prescription drug plan or enroll into a drug plan for the first time. When these things happen, CMS, Centers for Medicaid and Medicare Services, have to intervene on those beneficiaries behalf. There are different situations that people have for missing AEP and those situations have to fall into a special election period or be approved by CMS.

CMS Intervention

There are extreme situations that people experience that will force them to miss their AEP opportunity. When there is something that is rare and out of the norm that causes a beneficiary to miss their enrollment opportunity, they should call CMS immediately to speak with a representative. This is the first step to getting this concern addressed. As people begin to speak with the representatives, they will be able to discuss the specifics of their reasons for missing AEP. It is during that time beneficiaries will be told if they will be able to receive an override.

There will be some people that won’t be able to enroll because of their circumstances and missed opportunities. There are rules and criteria that CMS will use to make these decisions. Once CMS makers their decision, there is nothing that a private insurance carrier can do. These providers have to abide by rulings and decisions set forth by CMS.

SEP (Special Election Periods)

There are some people that don’t have to wait for an intervention from CMS. There are some that actually have circumstances that will allow them to enroll into a prescription drug plan during other times of the year. These times are predetermined and all Medicare Part D prescription drug plan providers recognize these times. Because these are recognized times, there shouldn’t be a problem with a beneficiary enrolling directly with the insurance provider.

People have many different things that happen in their lives. With those different things, they can be used to qualify for a special election period. Some examples of those SEP reasons are:

  • A beneficiary’s current plan gets terminated in the middle of the year.
  • A beneficiary is eligible and receiving both Medicare and Medicaid.
  • A beneficiary is receiving additional help to pay for their part D prescription drug plan.
  • A beneficiary has just moved back into the United States after living abroad.
  • A beneficiary has moved into an area their current plan isn’t available.

There are many other reasons people have that may qualify them for a special election period. When a beneficiary needs to enroll into a Medicare Part D prescription drug plan and the annual enrollment period has expired, it’s best for people to call the insurance provider they are interested in or to call CMS to discuss their circumstances directly.

The need for prescription drug insurance will always be. This is a need that more people need to take advantage of. Because this is something that is so important, it’s important that people enroll into the drug plan of their choice when the opportunity arises. If for any reason people miss those opportunities, they should still speak with a professional in the insurance company or CMS to discuss their options. These discussions could uncover an exception and allow them to enroll into the drug plan.

 

 

 

Dec. 9 12'

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