New CMS Guidance 30.5 – Medicare Advantage Open Enrollment Period (MA OEP)

August 3, 2018

There are several changes for 2019 Medicare Advantage (MA) enrollments.  Please review the important information below regarding new CMS Guidance for Section 30.5, Chapter 2 of the Medicare Managed Care Manual.

30.5 – Medicare Advantage Open Enrollment Period (MA OEP)

42 CFR 422.62(a)(3) (Rev. 1, Issued: July 31, 2018; Effective/Implementation: 01-01-2019)

During the MA OEP, MA plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP.

This chart outlines who can use the MA OEP and when:

Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MA-PD or MA-only plans can switch to:

• MA-PD
• MA-only
• Original Medicare (with or without a stand-alone Part D plan)

The effective date for an MA OEP election is the first of the month following receipt of the enrollment request.

NOTE: The MA OEP does not provide an opportunity for an individual enrolled in Original Medicare to join a MA plan. It also does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans. The MA OEP is not available for those enrolled in Medicare Savings Accounts or other Medicare health plan types (such as cost plans or PACE).

As always, we thank you for your support and cooperation. For questions or comments, please email us at Compliance@NSGACommunications.com or you may call the toll-free number listed below.

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