The Centers for Medicare & Medicaid Services (CMS) is in the process of finalizing the Marketing and Enrollment Guidelines to address the modifications to the enrollment periods for Medicare beneficiaries starting in 2011 required by the Patient Protection & Affordable Care Act (PPACA) that became law on March 23, 2010.
In the meantime, we want to share with you the extent of information that CMS has provided verbally to the Industry during their weekly MA and PDP group calls. We hope that this summary will help clarify information about Medicare enrollment changes that you may be reading or hearing about.
NOTE: It is important to remember that CMS has not issued final guidance and this information is only based on non-binding statements from CMS.
2011 Annual Enrollment Period (AEP)
There are no changes expected for the 2011 AEP that runs November 15 - December 31, 2010. All elections made during that time period will be effective on January 1, 2011.
Open Enrollment Period (OEP) replaced with Annual Disenrollment Period (ADP)
Starting in 2011, the OEP will no longer exist. In its place, CMS will implement an election period called the Medicare Advantage 45-Day Annual Disenrollment Period (ADP). The ADP will run from January 1 through February 14th. During the ADP, beneficiaries who are enrolled in a Medicare Advantage (MA) plan (either MA-only or MAPD) have one election available and may disenroll from that plan back to Original Medicare. Beneficiaries may also use the ADP to pick up a stand-alone Part D plan, regardless of whether or not they have had Part D coverage previously.
As required by PPACA, CMS will modify the 2012 AEP dates to October 15, 2011 through December 7, 2011. All elections made during that time period will be effective January 1st 2012.