AGENT GUIDEBOOK simplerhorizons.com Medicare Made Simple
ABOUT US Medicare Made Simple As a mother of four, I understand the value of building relationships based on trust, respect, and compassion. I bring this same approach to my work, where I focus on helping independent agents navigate the ever-changing Medicare industry. My agency is known for its commitment to the golden rule principle - treating others as you would want to be treated. This creates a warm and welcoming environment for agents looking to partner with our agency. With years of experience in the insurance industry, I am passionate about helping others succeed. I take a personalized approach to each agent's needs, ensuring that they have the support and resources necessary to build their own successful businesses. I hope this guidebook helps you as an independent agent simplify your business and focus on what you do best –simplifying Medicare for your clients! Elka Soussana AGENCY OWNER
FLOW CHART FLOW CHART Hey there! We’ve created this flow chart to show you the process from initial contracting, to finally marketing your business. It's important to know that each step in the chart has an expected timeframe before moving on to the next phase. The process starts with getting contracted and certified, which can take a few weeks to complete. Next up, you’ll need to some training, which can last a few days or even a few weeks depending on your commitment to learning. While you’re training, you can order supplies, such as business cards and flyers. Finally, once all these steps are done, you can start marketing your business. But remember, it's important to follow the flow chart's timing guidelines to make sure everything is done right. Skipping a step or rushing through things can lead to mistakes and hinder your success. Patience is key! 1 2 3 4 5 CONTRACTING TRAININGS CERTIFICATIONS SUPPLIES MARKETING Est. time to complete under 1 week w/ License or 30-days w/o License Steps 3-5 approx completion within 2 weeks Approx 2 weeks
CHECKLIST YOUR GETTING STARTED CHECKLIST 1 2 You can mark o tasks as you complete them, such as getting the necessary licenses and certifications, completing trainings, and setting up your marketing strategies. By following the checklist, you'll feel confident starting your practice and be able to provide top-notch service to your clients. They'll be impressed with your professionalism and expertise! We hope this guidebook's comprehensive checklist can help you get your business up and running smoothly. This handy tool supplements the flowchart and provides a step-by-step guide to ensure you don't miss anything important. CONTRACTING Est. time to complete under 1 week w/ License or 30-days w/o License Individual State Life/Health License Completed Contracting Kit Errors & Omissions Coverage Current AHIP Certification Simpler Horizons Onboarding Steps 3-5 approx completion 3 within 2 weeks Complete a Business Plan Medicare 101 Co-Op Procedures Medicaid and LIS GAIN Portal/Online Enrollments Approx 2 weeks National & Local Carriers Complete one certification a day Organize Carrier Plan Benefits Sales Rep Contact List Carrier Website & Enrollment sites CERTIFICATIONS 4 Carrier Kits Give-Aways Business Cards Personal Flyers Cheat Sheets; IRMAA, LIS, Templates TRAININGS 5 T65 ‘Dear Neighbor’ Letter Facebook Webinars LinkedIn COI’s; Dr’s, Pharmacies, CPA’s, Senior Centers, etc. SUPPLIES MARKETING
We hope this guidebook's comprehensive checklist can help you get your business up and running smoothly. This handy tool supplements the flowchart and provides a step -by-step guide to ensure you don't miss anything important. You can mark off tasks as you complete them, such as getting the necessary licenses and certifications, completing trainings, and setting up your marketing strategies. Flyers
NOTES
TRAINING CHECK-LIST AGA Portal Homework – AGA has a bunch of extremely useful webinars that you can watch at your convenience. We strongly suggest that you take the time to watch the following: Login to your AGA portal and Click: Agent Resources > Sales Training Agent Portal Training Sales Training Medicare Basics Training Co-op Procedures Training Remote Enrollment Training BUSINESS CHECK-LIST Download the AGA Mobile App - Visit your device’s app store (Apple or Android users only) and search for AGA Portal. Download the app, log in with your username and password, and start using Snap & Submit today! Get a Simpler Horizons email address or create a different business email. Get a professional headshot for marketing materials. Update or create a LinkedIn profile. Order carriers supplies from AGA. Get a set of Business cards. Simpler Horizons will cover your 1st order of 500 Simpler cards. AGA business cards can also be ordered as well through the AGA portal under the marketing tab. Please get WhatsApp on your phone! We have a special group dedicated to our Simpler agents and we want you on there. Order an Agent Bio from AGA Order Marketing Materials from AGA (Tri-folds, flyers, etc). They’ll mail you 100 flyers FREE each month. Get a personalized Medicare website.
BROKER RELATIONS TEAM Call or email to speak with a knowledgeable AGA Team Member to assist with all aspects of your business today. Phone: Email: 800-498-6880 [email protected] General Fax: Submission Fax: 800-630-6344 877-240-3095 SALES TEAM Reach your sales goals by working with your Regional Sales Manager to develop a marketing plan, leveraging AGA’s programs and services. AGA CONTACT LIST REV 4/3/2023 WA OR CA NV UT AZ NM CO KS MO OK TX HI AK AR LA MS AL GA SC NC TN KY FL ID MT WY ND SD NE MN IA WI MI IL IN OH PA NY ME NH VT MA CT WV VA DE NJ RI MD DC CONTACT REGION EXTENSION MOBILE E-MAIL Nick Sotelo Chief Sales Officer 2804 (714) 420-8844 [email protected] Jo Nelson Vice President of Sales (714) 975-3302 [email protected] Ken Rasmus Director of Carrier Operations 2833 (714) 615-6963 [email protected] Jason Bronston National Sales Director (818) 918-0668 [email protected] Melissa Carrillo Regional Sales Manager CA: San Diego 2939 (619) 717-0968 [email protected] Pat Sierota Regional Sales Manager AL, AR, LA, FL, GA, FL, KY, MS, NC, SC, TN (770) 722-5934 [email protected] Dulce Tee-Sy Regional Sales Manager CA: Inland Empire AZ, CO, NM, NV, UT 2911 (323) 439-3572 [email protected] Louis Valladares Regional Sales Manager CA: Orange County Northern CA 2828 (714) 348-0255 [email protected] Kathleen Llado-Franzke Regional Sales Manager CA: Los Angeles (818) 751-4983 [email protected] Irving Mares Regional Sales Manager HI, ID, MT, ND, NE, OK, OR, SD, TX, WY 2811 (714) 944-9794 [email protected] Trina Townsend Regional Sales Manager IA, IL, IN, KS, MI, MN, MO, OH, WI 2981 (920) 370-3881 [email protected] Nicole Salas Regional Sales Manager CT, DC, DE, MA, MD, ME, NJ, NH, NY, PA, VA, VT, WV 2829 (714) 612-9720 [email protected]
Carrier Medicare Website Aetna http://www.aetnamedicare.com/ https://www.aetna.com Alignment http://www.alignmenthealthplan.com/default.aspx https://agents.alignmen AHIP Medicare https://www.ahipmedicaretraining.com/ https://www.ahipmedica American National https://www.americannational.com Anthem Blue Cross - CA, CO http://www.anthem.com/ www.anthem.com/home Blue Shield CA https://www.blueshieldca.com/ https://www.blueshieldc Brand New Day https://bndhmo.com/ https://bndhmo.com/br Bright Idea Dental & Vision www.brightideadental.com Care1st https://www.care1st.com/ https://online.care1st.c CareMore http://www.caremore.com/ https://www.caremore.c Central Health https://www.centralhealthplan.com/ https://www.centralhea Cigna - Loyal American Med Supp www.cigna.com/medicare/supplemental/ Continental Life - Aetna Med Supp www.aetnaseniorproducts.com www.aetnaseniorproduc Easy Choice - CA Only http://easychoicehealthplan.com/ http://easychoicehealth Gerber www.gerberlife.com https://www.gerberlife.c Golden State https://www.gsmhp.com/ Humana http://www.humana-medicare.com/ http://www.humana.com IMG Travel Ins. http://www.imglobal.com/ https://producer.imglob InterValley https://www.ivhp.com/ Legacy Full Circle http://www.legacyfullcircle.com/ http://www.lfcagency.co Manhattan Life www.manhattanlife.com/Medicare-Supplement-Insurance https://producer.manha Mutual of Omaha www.mutualofomaha.com/medicare-supplement-insurance/ SCAN https://www.scanhealthplan.com/ https://www.scanhealth Scott & White https://www.swhp.org/ https://www.swhp.org/a Sentinel Security Life www.sslco.com/products https://www.sslco.com/ SilverScript https://www.silverscript.com/ www.SilverScriptAgentP United American https://www.unitedamerican.com https://www.unitedame United Healthcare https://www.uhcmedicaresolutions.com/ www.unitedhealthprodu WellCare https://www.wellcare.com/ https://www.wellcare.co
Broker Portal Broker Support Broker Support Email /producer/ 866-714-9301 [email protected] nthealthcare.com/login?HP=AHP 888-793-5700 [email protected] aretraining.com/ 866-234-6909 Support@AHIPInsurance Education.org e-brokers.html 888-209-7839 ca.com/producer/ 800-559-5905 [email protected] rokers/ om/broker/ 866-922-4368 com/Brokers/Contact.aspx 866-660-7037 [email protected] lthplan.com/broker (626) 388-2375 [email protected] cts.com/ssi/asp_agent_home.html 800-264-4000 x3 plan.com/brokers.php 855-497-7460 [email protected] com/gl/ap/view/agency/login.jsp m/agents/ 800-309-3163 [email protected] bal.com/login.aspx 866-368-3724 [email protected] 800-251-8191 om/login 877-214-3013 [email protected] attanlife.com/life/account/login.aspx hplan.com/brokers/brokers-contact-page 888-445-2038 agents-brokers 866-781-7008 /agents.aspx 800-247-1423 [email protected] Portal.com 888-277-4174 [email protected] erican.com/logon/ 800-925-7355 [email protected] cers.com/ 888-381-8581 [email protected] om/en/Producers Varies by State [email protected]
Carrier Name Broker Website Writing ID Username Password
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Center for Medicare 7500 Security Boulevard Baltimore, Maryland 21244-1850 MEDICARE DRUG & HEALTH PLAN CONTRACT ADMINISTRATION GROUP DATE: TO: FROM: June , 2022 Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Section 1876 Cost Plans, and Medicare-Medicaid Plans Kathryn A. Coleman Director SUBJECT: Contract Year 2023 Agent and Broker Compensation Rates, Referral/Finder’s Fees, Submissions, and Training and Testing Requirements This memorandum provides Contract Year (CY) 2023 compensation and referral/finder’s fee limits for agents and brokers, directions for submitting amounts into the Health Plan Management System (HPMS), as well as training and testing requirements. Compensation Rates and Referral/Finder’s Fees for CY 2023 As provided in 42 C.F.R. §§ 422.2274(d)(2) and 423.2274(d)(2), the compensation amount an organization pays to an independent agent or broker for an initial enrollment must be at or below the fair market value (FMV). 42 C.F.R. §§ 422.2274(d)(3) and 423.2274(d)(3) limit renewal compensation to a maximum of 50% of the FMV. 42 C.F.R. §§422.2274(f) and 423.2274(f) limit the amount an organization may pay for referrals. Each year, CMS publishes the FMV amounts for initial and renewal compensation as well as referral fees. The amounts are as follows: Medicare Advantage and Section 1876 Cost Plans Compensation Type National Connecticut, Pennsylvania, District of Columbia California New Jersey Puerto Rico, U.S. Virgin Islands Initial Year $601 $678 $750 $411 Renewal Years $301 $339 $375 $206 PDPs Initial Year $92 Renewal Years $46 Referral Fees MA Plans $100 PDP Plans $25 NOTE: CMS rounded the FMV amounts for CY 2023 up to the nearest dollar. The Initial Year amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-year 1. The renewal amount is the maximum allowable amount that
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 1 Rev. 11222023JT 2023 Commission Payment Cycles Compensation: Initial Compensation: Is paid for a beneficiary’s first year of enrollment in Medicare. There are also limited other instances of initial enrollment, such as enrolling in an "unlike plan type." All MAPD plans are considered "like plans." All enrollments eligible for initial payment will be determined retroactively by CMS and the difference between the renewal amount and the initial payment will be paid after CMS notification. Alternatively, the carrier may chargeback the renewal amount, then repay the new to Medicare amount. Renewal Compensation: Renewal plan years are everything after the initial year. All enrollments will be considered renewal enrollments until determined by CMS. The calendar year is considered the year. If a member enrolls on June 1st for their initial year, the renewal year still starts on Jan. 1 st . Pro-rated Compensation: CMS guidelines indicate that an agent can only receive compensation for the months that a beneficiary is actually enrolled. This means that if the beneficiary is enrolled in a plan for only part of the year, the carrier must only pay for the months the beneficiary was enrolled. The rest of the compensation paid must be recovered. The only exception to this is that the carrier may pay the entire initial year compensation, if they choose.
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 2 Commission Payment Cycle AGA pays agent commissions three times per month (i.e., the 10th, 20th and 30th). For the commissions that AGA pays the agents, AGA schedules the payment on the next available commission run after receipt of payment by the carrier. CMS has written guidelines as to when the commissions can be paid. They have indicated that commissions can only be paid in the current year of the policy. This means that carriers that used to pay on application submission can no longer pay prior to the effective month if the effective month is not in the current year. The impact is that during Open Enrollment, no carrier is permitted to pay compensation prior to the 1st of the year. Although there is some variation, payment for the carriers usually occurs as follows: Carrier Agent paid (by) Payment Covers Aetna Direct Pays based on submitted date. Issued within 2-4 weeks of submission. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/28/23. AgeWell Direct Pays based on submitted date. Issued within 2-4 weeks of submission. Alignment AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Anthem AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. Aspire AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/28/23. Astiva Health AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. Asuris Northwest Health Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/20/23. Baylor Scott & White Health Plan Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/20/23. BCBS AZ AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. BCBS KC Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. BCBS IL, NM, MT, OK, TX Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Blue Shield Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/20/23. Brand New Day AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. Bright Health Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/20/23. CalOptima AGA Pays based on submitted date. Issued within 2-4 weeks of submission. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. CarePartners of Connecticut* TBD TBD
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 3 Carrier Agent paid (by) Payment Covers Centene Direct Pays based on submitted date. Issued within 2-4 weeks of submission. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Agent must opt in to direct pay in Centene Portal. Central Health AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. CIGNA Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. Clear Spring Health Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Clever Care Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. Clover Health AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Commonwealth Care Alliance AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/28/23. Denver Health AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Devoted Health Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Elderplan NY Direct Pays based on submitted date. Issued within 2-4 weeks of submission. Emblem Health Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/28/23. Eternal Health* TBD TBD Essence Healthcare (previously Stanford Health) Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/10/23. Fallon Health* TBD TBD Florida Blue Direct Pays based on submitted date. Issued within 2-4 weeks of submission. Freedom Health/Optimum Healthcare Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. GlobalHealth AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Harvard Pilgrim Health* TBD TBD Healthfirst Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Health New England* TBD TBD Horizon BCBS of NJ Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Humana Direct Pays based on submitted date. Issued within 2-4 weeks of submission. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/10/23. Imperial Health AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23.
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 4 Carrier Agent paid (by) Payment Covers Indiana University Direct TBD Innovative Integrated Health Community Plans (IIHCP) AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Inter Valley AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/20/23. Kaiser Permanente Integrity/ AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. L.A. Care AGA Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/20/23. Mass Advantage* TBD TBD Molina Direct Pays on the prior effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/20/23. Oscar Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Prominence Health Plan AGA Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Providence Health Plan Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Regence Blue Shield Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. SCAN Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. SelectHealth Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Sonder Health Plans Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Tufts Health Plan TBD TBD UnitedHealthcare Direct Pays based on submitted date. Issued within 2-4 weeks of submission. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Welbe Health (MediCal (PACE)) Direct Pays on the same effective month. 1/1/23 effective policies and renewals for 1/2023 should be paid by 01/30/23. Zing Health Direct Pays based on submitted date. Issued within 2-4 weeks of submission. 1/1/23 effective policies and renewals for 1/2023 should be paid by 02/28/23. AGA pays the agent on the next commission cycle after receiving payment from the carrier. At times, the carrier may pay late. If this is the case, AGA will pay on the commission run after receipt from the carrier. Duration of Commission Payments With the new CMS guidelines, carriers are permitted to pay the agent renewals. The following carriers have opted for lifetime renewals, for as long as the member is still enrolled with the carrier: Aetna Alignment Anthem Aspire Astiva Health BCBS AZ
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 5 BCBS KC BCBS IL, NM, MT, OK, TX Blue Shield Brand New Day Bright Health CalOptima Centene Central Health Cigna Clear Spring Health Clever Care Denver Health Devoted Health Elderplan NY Emblem Essence Healthcare Florida Blue Freedom Health/ Optimum Healthcare GlobalHealth Golden State Healthfirst Humana Imperial Health Indiana University Innovative Integrated Health Community Plans (IIHCP) Inter Valley L.A. Care Molina Oscar Providence Health Plan Prominence Health Plan SCAN SelectHealth Regence Blue Shield UnitedHealthcare Zing Health The following carrier has opted for 10-year renewals, for as long as the member is still enrolled with the carrier: AgeWell Asuris Northwest Health Clover Health The following carrier has opted for 7-year renewals, for as long as the member is still enrolled with the carrier: Baylor Scott & White Health Plan The following carrier has opted for 20-year renewals, for as long as the member is still enrolled with the carrier: Welbe Health (Medi-Cal (PACE)) Please refer to the carrier contract for specific details in your state or request the information from your sales manager. Commission Amounts Paid As noted above, there are initial commissions and renewal commissions. Carriers pay the initial amount as a renewal. When they receive notification from CMS that the enrollee is new to Medicare, they will then pay the remaining new to Medicare amount (sometimes called a True-Up). CMS has guidelines on the amount of commissions that can be paid to the agents. The following is the maximum amount that can be paid to an agent. Some carriers have reduced commissions on specific plans, or have reduced commissions in specific service areas. Please be sure to check those items specifically for an area or plan, as they may be lower than the CMS-approved amounts. These amounts also vary by state.
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 6 2023 CMS APPROVED MAPD AMOUNTS Compensation Type California, New Jersey Connecticut, Pennsylvania, District of Columbia National New to Medicare $750 $678 $601 Renewal Amount $375 $339 $301 IMPORTANT NOTES: (1) Renewal commissions that are new to the carrier are paid at a pro-rated amount. For example: A 5/1/2023 effective MAPD plan (not new to Medicare) will be paid 8 months of commissions @ $31.25 per month for a total of $250.00. Your renewals will then start in January of 2024 instead of the plan anniversary date. (2) The CMS approved MAPD compensation amounts vary by state. For your state-specific amounts, please review the commission schedules. Commission Chargeback Policy Carrier Full Chargeback Occurs Before Which Month? Aetna 4 months AgeWell 3 months Alignment 4 months Anthem 3 months Aspire 3 months Astiva Health 4 months Asuris Northwest Health 3 months Baylor Scott & White Health Plan 3 months BCBS AZ 3 months BCBS KC 4 months Blue Shield 3 months Brand New Day 4 months Bright Health 3 months CalOptima 3 months Centene 3 months Central Health 3 months Cigna 3 months Clear Spring Health 3 months Clever Care 3 months Clover Health 3 months Community Care 3 months Denver Health 3 months
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 7 Carrier Full Chargeback Occurs Before Which Month? Devoted Health 3 months Elderplan NY 4 months Emblem Health 3 months Essence Healthcare 3 months Freedom Health/Optimum Healthcare 3 months Florida Blue 4 months Global Health 3 months Golden State 3 months Healthfirst 3 months Humana 3 months Imperial Health 3 months Indiana University 3 months Innovative Integrated Health Community Plans (IIHCP) 3 months Inter Valley 3 months L.A. Care 3 months Molina 3 months Oscar 3 months Providence Health Plan 3 months Prominence Health Plan 3 months SCAN 4 months SelectHealth 3 months Sonder Health Plans GA 3 months UnitedHealthcare 3 months Vitality Health Plan 3 months Welbe Health (Medi-Cal (PACE)) 3 months Zing Health 3 months If a member elects to drop coverage within a 12-month period, the lump sum payment will be pro-rated and deducted from future commission payments or collected. This 12-month pro-rated chargeback applies to all carriers. As you may be aware, CMS regulations have changed regarding back-charging of commissions. In the past commissions were only charged back for rapid disenrollments (a member who disenrolled within 3 to 4 months, depending on the carrier, of the effective date). Now CMS will chargeback not only for rapid disenrollments, but also pro-rating the commissions for 12 months. Let’s look at an example to make the process clearer. Let’s say a carrier has a 3-month rapid disenrollment policy: Commissions advance of $375.00 will be paid to the agent. Rapid Disenrollment – agent will be back charged for $375.00.
*This serves as a guide and not a binding contract. See your carrier contract for the exact details. Page 8 Pro-rate Chargeback example: If the agent commission amount is $375.00 and the member stays enrolled through: CALIFORNIA Effective for x Months Chargeback for these Months Action Chargeback Amount 4 8 Back-charge ($250.00) 5 7 Back-charge ($218.75) 6 6 Back-charge ($187.50) 7 5 Back-charge ($156.25) 8 4 Back-charge ($125.00) 9 3 Back-charge ($93.75) 10 2 Back-charge ($62.50) 11 1 Back-charge ($31.25) 12 0 Back-charge - Note: After the 12 months of enrollment, agent will receive monthly commission amounts of $31.25 through the end of the renewal cycle. ********* If the agent commission amount is $301.00 and the member stays enrolled through: NATIONAL Effective for x Months Chargeback for these Months Action Chargeback Amount 4 8 Back-charge ($200.64) 5 7 Back-charge ($175.56) 6 6 Back-charge ($150.48) 7 5 Back-charge ($125.40) 8 4 Back-charge ($100.32) 9 3 Back-charge ($75.24) 10 2 Back-charge ($50.16) 11 1 Back-charge ($25.08) 12 0 Back-charge - Note: After the 12 months of enrollment, agent will receive monthly commission amounts of $25.08 through the end of the renewal cycle.
PART A Hospital Insurance $1,600 deductible per benefit period; days 1–60 $0, days 61–90; $400 coinsurance per day, days 91+; $800 coinsurance per day (2023). www.medicare.gov/coverage/inpatient-hospital-care Skilled nursing facility, no cost for days 1–20, $200 coinsurance per day for days 21–100, all costs for all days after 100 (2023). www.medicare.gov/coverage/skilled-nursing-facility-snf-care PART B Medical Insurance The standard Part B premium in 2023 is $164.90 each month (or higher depending on income). However, most people who get Social Security benefits will pay less than this amount. $226 annual deductible (2023). After deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services. www.medicare.gov/your-medicare-costs/part-b-costs PART C Medicare Advantage (HMOs and PPOs) Medicare Advantage Plans offer robust coverage, which may include additional benefits. Prescription Drug Plans are included in most plans with no additional premium. www.medicare.gov/media/10991 (page 5) PART D Prescription Drug Coverage Premiums vary depending on plan choice. $505 annual deductible (2023). Initial coverage limit is $4,660 and TROOP is $7,400 (2023). Catastrophic coverage assures you only pay a small coinsurance/ copayment amount for drugs for the rest of the 2023. www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage Medicare Supplement Medicare Supplement, also called Medigap, helps pay for costs Original Medicare does not cover like copayments, coinsurance, and deductibles. Does not offer prescription drug coverage. You pay a monthly premium in addition to Part B and Part D premiums. www.medicare.gov/media/10991 (page 75) Medicare Basics You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium, and or copayments/coinsurance may change on January 1 of each 2023.
PART B IRMAA CHAR
CHART RTS (2 PAGES)
PART D
CHART
Needs Analysis Worksheet Name Address City State Zip Code County Phone FOR AGENT USE ONLY Are you currently covered through your employer? Yes No If yes, do you have out-of-pocket costs? Yes No Premiums? Yes: No Co-pays? Yes: No Deductibles? Yes: No Drug cost shares? Yes: No Medicare Card? Yes No Medicare Part A B Medicaid/MediCal Card? Yes No Which is most important to you? Doctor Specialist Hospital Do you use mail order? Yes No Current Health/Drug Plan Name Other drug coverage such as VA, retirement plan, etc. Preferred Pharmacy Current PCP Current Specialist Hospital Preference Current Dental Plan Current Vision Plan 102401P Is transportation provided with your current plan? Yes No
1. Prescription Name Strength Dosage Brand Generic 2. Prescription Name Strength Dosage Brand Generic 3. Prescription Name Strength Dosage Brand Generic 4. Prescription Name Strength Dosage Brand Generic 5. Prescription Name Strength Dosage Brand Generic 6. Prescription Name Strength Dosage Brand Generic 7. Prescription Name Strength Dosage Brand Generic 8. Prescription Name Strength Dosage Brand Generic 9. Prescription Name Strength Dosage Brand Generic 10. Prescription Name Strength Dosage Brand Generic Needs Analysis Worksheet 102401P Would you like information on Low Income Subsidy to assist with the cost of your prescriptions? Yes No Do you have any chronic conditions such as Asthma, COPD, Cardiovascular Disease (CVD), Congestive Heart Failure (CHF), Dementia, Diabetes, Hypertension, etc? Explain:
© 2018 Medicare Rights Center Last Updated: January 2018 Special Enrollment Periods fo and Medicare Part D Drug Pla You’re limited in when and how often you can join, change or le private health plan) or drug plan (Part D). You can enroll in a Medicare Advantage or Part D plan d During the first 45 days of each year (the Medicare Adva February 14), you can leave your Medicare Advantage P selecting a separate stand-alone Medicare drug plan. Yo if you have Original Medicare. You can’t switch from one During Fall Open Enrollment, October 15 through Decem Medicare health coverage and enroll in, change or drop M Outside of the above three periods, you can only change drop Part D drug coverage if you qualify for a Special En 1 The information in this chart comes from the “Medicare Prescription Drug Manual: Eligi Manual: Medicare Advantage Enrollment and Disenrollment, Section 30.” 2 Eligibility requirements and initial enrollment periods for Medicare Advantage and Part D A, Part B or both and live in the service area of a Medicare Part D drug plan. The Part D In which is the seven-month period that begins three months before you qualify for Part B an Advantage Plan if you have both Parts A and B. You usually can’t get a Medicare Advant (ICEP) for Medicare Advantage begins three months before you are enrolled in both Parts and B or the last day of your Part B initial enrollment period, whichever is later.
or Medicare Advantage Plans ans 1 eave a Medicare Advantage Plan (also known as a Medicare during the initial period when you first qualify for Medicare. 2 antage Disenrollment Period, or MADP, January 1 through Plan and change to Original Medicare with or without also ou can’t make any changes to your coverage during this period Medicare Advantage Plan to another during this period. mber 7 of each year, you can change how you get your Medicare drug coverage. e how you get your health coverage and enroll in, change or rollment Period (SEP). ibility, Enrollment and Disenrollment, Section 30” and the “Medicare Managed Care D are different. You’re eligible to enroll in a Medicare Part D drug plan if you have Part nitial Enrollment Period is usually the same as the Initial Enrollment Period for Part B, nd ends three months after the month you qualify. You’re eligible to enroll in a Medicare tage Plan if you have End-Stage Renal Disease. The Initial Coverage Election Period A and B and ends either the last day of the month before you enrolled in both Parts A
© 2018 Medicare Rights Center Special Enrollment Periods The length of the Special Enrollment Period (SEP) and the ef reason for the SEP. The plan and, in some cases, the Center whether you qualify for an SEP. The SEPs in the tables below let you change your Medica for changing Medicare drug plans are the same whether you Medicare Advantage Plan that covers both health care and d Retroactive Disenrollment In some cases, CMS may let you retroactively disenroll from the disenrollment starts. For example, if you thought you were into joining a Medicare Advantage Plan that includes drug co back to the date you first joined the Medicare Advantage Plan If you’re granted retroactive disenrollment, it would be as if yo will likely take back any payments it made for your health car health and drug coverage for the period for which you were re insurance that will pay bills from the retroactive period. Or yo coverage you had before enrolling in the plan you didn’t want want would have to be resubmitted to that other plan. If you got a lot of health care and drugs while in the plan you request retroactive disenrollment. You can also request prosp forward. In this case the plan won’t recoup payments it’s alre If you want to switch from one plan to another, it’s usual You’ll be automatically disenrolled from your old plan. It’s bes calling the plan directly.
ffective date of your new coverage vary depending on the rs for Medicare & Medicaid Services (CMS), determine are Advantage Plan, Medicare drug plan or both. The rules are in a stand-alone drug plan that only covers drugs or a rugs. your Medicare Advantage or drug plan. CMS decides the date e enrolling in a stand-alone drug plan but instead were misled verage, you can request for your plan disenrollment to go n. ou never enrolled in the Medicare Advantage Plan. The plan re and drugs. In this case, you’ll want to make sure you have etroactively disenrolled. You may have another type of u may request retroactive reinstatement into the Medicare t. Bills for care and drugs you got while in the plan you didn’t didn’t want, think carefully about whether it’s a good idea to pective disenrollment, which will change your coverage going ady made. ly better to just enroll in the plan you want to enroll in. st to call 1-800-MEDICARE to enroll in a new plan rather than
© 2018 Medicare Rights Center Premium Penalty for Late Enrollment into Part D If you don’t enroll in Part D when you’re first eligible, and you d (creditable coverage) for 63 days or more, you’ll likely have to p While SEPs let you enroll in Part D outside of a standard enroll D enrollment in many cases. There are two exceptions: You wo program that helps pay for most of the costs of the Medicare dr about the creditability of your other drug coverage. Table of Contents The table in the following pages explains when a Special Enr and when your new coverage will begin. If you qualify for diffe convenient for your circumstances. 1. You have creditable drug coverage or lose creditable cov 2. You choose to change employer/union coverage (throug 3. You’re institutionalized 4. You’re enrolled in a State Pharmaceutical Assistance Pro 5. You have Extra Help, Medicaid or a Medicare Savings P 6. You want to disenroll from your first Medicare Advantage 7. You enroll in/disenroll from PACE (Program of All-Inclusi 8. You move (permanently change your home address) 9. You’ve had Medicare eligibility issues 10.You’re eligible for a Special Needs Plan (SNP) or lose el 11.You experience contract violations or enrollment errors 12.Your plan no longer offers coverage 13. You disenroll from your Medicare Advantage Plan during 14. You qualify for a new Part D initial enrollment period whe 15. You want to enroll in a five-star Medicare Advantage Pla 16. You have been in a consistently low-performing Medicar 17. Your Medicare Advantage Plan terminates a significant 18. You experience an “exceptional circumstance”
on’t have drug coverage that is at least as good as Medicare’s pay a premium penalty if you later enroll in a Part D plan. ment period, you will still owe a premium penalty for late Part on’t have a penalty if you qualify for Extra Help—a federal rug benefit—or if you show that you got inadequate information rollment Period may apply to you, how long each SEP lasts, erent SEPs at the same time, pick the one that is most verage through no fault of your own h either current or past employment) ogram (SPAP) rogram e Plan ve Care for the Elderly) igibility for your SNP g the Medicare Advantage Disenrollment Period en you turn 65 an or Part D plan re Advantage or Part D plan amount of its network providers
© 2018 Medicare Rights Center Special Enrollment Periods 1. You lose creditable drug coverage through no creditable coverage. You have an SEP if… Your SEP You, through no fault of your own, lose drug coverage that is at least as good as or better than Medicare’s (creditable) or your drug coverage is reduced so that it is no longer creditable. (This does not include losing your drug coverage because you do not pay, or cannot afford, your premiums.) Your SEP to join a Me Plan with drug coverag Medicare Part D drug month you are told yo and lasts for 2 months after coverage; or 2 months after whichever is lat You want to disenroll from Medicare drug coverage to maintain or enroll in another type of creditable drug coverage such as VA, TRICARE, or a state pharmaceutical assistance program (SPAP) that offers creditable coverage. You can use this SEP Medicare Advantage P coverage or a stand-a drug plan whenever yo in another type of cre 2. You join or drop employer/union health and/o creditable. Employer coverage may be current o You have an SEP if… Your SEP You choose to: enroll in or disenroll from a employer/union-sponsored Medicare Advantage Plan or Part D plan disenroll from a Medicare Advantage Plan or Part D plan to take employer/union-sponsored coverage. disenroll from employer/unionYour SEP to join or d Medicare Advantage P or to switch Medicare Part D plans is availab have or are enrolling i and ends two months which your employer o ends.
o fault of your own or want to keep or enroll in P lasts… Your coverage begins… edicare Advantage ge or a stand-alone plan begins the ur coverage will end you lose your you receive notice, ter. The first day of the month after you submit a completed application; or Up to 2 months after your SEP ends, if you request it. to disenroll from a Plan with drug alone Medicare Part D ou are able to enroll editable coverage. The first day of the month after your plan receives your disenrollment request. or drug coverage regardless of whether it is or former (retiree plan). P lasts… Your coverage begins… isenroll from a Plan or Part D plan, e Advantage Plans or ble to persons who n an employer plan after the month in or union coverage Up to three months after the month in which you submit a completed enrollment application. If your employer/union was late sending in the application, your coverage may begin retroactive to when you submitted the application.
© 2018 Medicare Rights Center sponsored coverage of any kind (including COBRA3 ) to enroll in a Medicare Advantage Plan or Part D plan. 3. You’re institutionalized. You have an SEP if… Your SEP You move into, reside in, or move out of a qualified institutional facility: a skilled nursing facility, nursing home, psychiatric hospital or unit, Intermediate Care Facility for the Mentally Retarded—ICF/MR, rehabilitation hospital or unit, long-term care hospital, or swing-bed hospital4 or; You qualify to enroll in a Special Needs Plan (SNP) for institutionalized people5 Once you move to or r institution, you can en from a Medicare Adv D plan or change you month. (If you are in a Advantage Plan, you m another Medicare Adv change to Original Me In addition, after you m facility, you have two m disenroll from a Medi or Part D plan, or to sw (including Original Me Medicare Advantage P You can enroll in or di for institutionalized pe 3 If you are disenrolling from COBRA and signing up for a Medicare Advantage Plan you without penalty if you have health insurance from a current employer. COBRA is not con a Part D plan. 4 Only residents of a skilled nursing facility, nursing home, psychiatric hospital or ICF/MR 2011. 5 You qualify for an institutional SNP if you: (1) Have lived, for at least 90 days, in a long requiring an institutional level of care for at least 90 days, whether you live in an institutio qualify for an institutional SNP before you have received care for at least 90 days if it is lik
P lasts… Your coverage begins… reside in a qualified nroll in or disenroll vantage Plan or Part ur plan once a an Medicare may change to vantage Plan or edicare) move out of the months to enroll in or care Advantage Plan witch to another plan dicare if you are in a Plan). senroll from the SNP ople at any time. The first day of the month after you submit a completed application, but not before you become institutionalized or qualify to enroll in a Special Needs Plan for institutionalized people. must already have enrolled in Parts A and B. You can only delay enrollment into Part B nsidered current employer insurance. You do not need to have Medicare Part B to enroll in R will be eligible to pay a $0 copay for prescription drugs with Extra Help in 2010 and g-term care facility that is served by the SNP or (2) have met your state's guidelines for on or in a community setting (for example, at home or in a group residence). You can still kely that you will need long-term care for at least 90 days.
© 2018 Medicare Rights Center 4. You’re enrolled in a qualified State Pharmace SPAP eligibility. You have an SEP if… Your SEP You’re enrolled in a qualified SPAP (no matter how long you have been a member). You have an SEP to c year, at any time durin Medicare Advantage P for the first time or to c Medicare Advantage P including joining one t SPAP. (If you are auto a Part D plan by your have this SEP.) You may not drop Pa this SEP. You lose SPAP eligibility You have an SEP to jo another Medicare Part Advantage Plan with d applies even if you did before. The SEP starts the SPAP because yo or are notified of the lo comes first) and contin after you’re notified of SPAP (whichever com 5. You have Medicaid, a Medicare Savings Prog Part D premium penalty if you have Extra Help.) You have an SEP if… Your SEP You have Medicaid, a Medicare Savings Program (MSP) or Supplemental Security Insurance (SSI). (You get Extra Help You will get an SEP to from6 or switch Medi Plans or Part D plans 6 Don’t drop Part D coverage if you have Medicaid! In most cases you will los office.
eutical Assistance Program (SPAP) or lose P lasts… Your coverage begins… choose once per ng the year, to join a Plan or Part D plan change to another Plan or Part D plan, hat works with your omatically enrolled in SPAP, you will not art D coverage using The first day of the month after you submit a completed application. oin or switch to t D plan or Medicare drug coverage. This dn’t have Part D s the month you lose ou’re no longer eligible oss (whichever nuing for two months the loss or lose the mes later). The first day of the month after you submit a completed application. ram (MSP) and/or Extra Help. (You will have no ) P lasts… Your coverage begins… o join, disenroll care Advantage beginning the month The first day of the month after you submit a completed application to the Medicare Advantage Plan or Part D plan. se your Medicaid benefits. For more information, call your local Medicaid
© 2018 Medicare Rights Center automatically.) you become eligible fo MSP. As long as you have M you can switch healt once a month. You have Extra Help because you applied for it. (You do not have Medicaid or a Medicare Savings Program.) You will get an SEP to or switch Medicare p beginning the month y for Extra Help. This inc Part D prescription dru Medicare Advantage P coverage. As long as you have E
or Medicaid or the Medicaid or an MSP, th or drug plans If you do not select a Part D plan yourself, CMS will auto-enroll you in a Part D plan effective the first day of the second month after CMS identifies your Extra Help status. CMS will enroll you in the Limited Income NET (LINET) program through Humana from the month you qualified for Extra Help until the month your auto-enrolled plan starts. If you recently qualified for Extra Help and choose your own Medicare Part D plan instead of waiting to be auto-enrolled in one by CMS, you may receive coverage of any uncovered months through the Limited Income NET program through Humana. If you enroll in a Medicare Advantage Plan without drug coverage, Medicare will automatically enroll you in a Medicare Advantage Plan with drug coverage offered by that same company. Your Medicare Advantage Plan with drug coverage enrollment could be retroactive. o join, disenroll from rivate drug plans you become eligible cludes stand-alone ug plans and Plans with drug Extra Help, you can The first day of the month after you submit a completed application to the Part D plan. If you do not select a Part D plan yourself, CMS will auto-enroll you in a Part D plan effective the first day of the second month after CMS identifies your Extra Help status. CMS will enroll you in the Limited Income NET (LINET) program
© 2018 Medicare Rights Center switch drug plans on You lose Medicaid or MSP benefits7 . You have one SEP to Medicare Advantage P that begins the month you will lose Medicaid continues for two mon You will lose Extra Help for the next calendar year because you are no longer deemed eligible for it. (You are deemed eligible if you are enrolled in Medicaid, an MSP or SSI.) You have a one-time S from or switch your M Plan or Part D plan fro you were notified you before January 1. You lose Extra Help during the calendar year (occurs in limited circumstances) You have a one-time S from or switch your M Plan or Part D plan for you are notified of losi 6. You want to disenroll from your FIRST Medica You have an SEP if… Your SEP You select a Medicare Advantage private health plan when you first qualify for You can disenroll from Advantage Plan at any 7 If you lose your Medicaid or MSP benefits your Extra Help will continue. If you are dee 1 and June 30, then you are eligible for Extra Help for the remainder of the calendar year. eligible for Extra Help for the remainder of that calendar year and the following calendar y
nce a month. through Humana from the month you qualified for Extra Help until the month your auto-enrolled plan starts. If you recently qualified for Extra Help and choose your own Medicare private drug plan instead of waiting to be auto-enrolled in one by CMS, you may receive coverage of any uncovered months through the Limited Income NET (LINET) program through Humana. switch your Plan or Part D plan you’re notified that or MSP benefits and nths after. The first day of the month after you submit a completed application. SEP to disenroll Medicare Advantage om January–March if lost Extra Help The first day of the month after you submit a completed application. SEP to disenroll Medicare Advantage r two months after ing Extra Help. The first day of the month after you submit a completed application are Advantage Plan. P lasts… Your coverage begins… m your Medicare y time during the 12- Depends upon the situation. emed eligible for Extra Help by either having Medicaid, SSI or an MSP between January If you are deemed eligible for Extra Help between July 1 and December 31 you will be year.
© 2018 Medicare Rights Center Medicare Part B based on age (65 years old) 8 months after your hea started and go back to with or without joining Medicare Part D drug You dropped your Medigap policy to enroll in a Medicare Advantage Plan for the first time and want to re-enroll in a Medigap policy during your “trial period.”9 The trial period lasts for 12 months after you enroll in a Medicare private health plan for the first time. You can disenroll from Advantage Plan at any period – the 12-month Advantage coverage f back to Original Medic joining a stand-alone M plan. 7. You enroll in/disenroll from PACE (Program o You have an SEP if… Your SEP You disenroll from a Medicare Advantage Plan or Part D plan to enroll in PACE. You can disenroll from Advantage or Part D p enroll in PACE. You disenroll from PACE to join a Medicare Advantage Plan or Part D plan. Your SEP to join anot Advantage Plan or Pa two months after the e disenrollment from the 8. You move (permanently change your home ad You have an SEP if… Your SEP You move, permanently. You will have an SEP if you move out of your Medicare Advantage Plan’s or Part D plan’s service area or if you move to an area covered by your plan but more plans are available to you in your new coverage area. If you notify your Me Plan or Part D plan o in advance, you have another Medicare Adv beginning as early as your move and lasting 8 In this instance, under federal law if you joined a Medicare Advantage Plan when you fir Medigap policies. Laws in your state may offer additional protections. 9 In this instance, under federal law if you are 65 and over, you will have guaranteed issue protections.
alth plan coverage first o Original Medicare a stand-alone plan. m your Medicare y time during the trial hs after your Medicare first started-- and go care with or without Medicare Part D drug Depends upon the situation. of All-Inclusive Care for Elderly). P lasts… Your coverage begins… m your Medicare plan at any time to Depends upon the situation. ther Medicare art D plan lasts up to effective date of your e PACE program. Depends upon the situation. ddress). P lasts… Your coverage begins… edicare Advantage of a permanent move e an SEP to switch to vantage or Part D plan the month before g up to two months You may choose to begin coverage any time between the first day of the month you moved (as long as you have submitted a completed application), and up to three months after your Medicare Advantage Plan or Part D plan receives the completed rst qualified for Medicare at age 65, you would have guaranteed issue rights to buy certain rights to buy certain Medigap policies. Laws in your state may offer additional
© 2018 Medicare Rights Center after the move. If you notify your Me or Part D plan of a pe after you move, you h switch to another priv plan, beginning the mo plan, plus two more fu If you did not notify y or drug plan about a and your Medi learns from CM that you moved ago, the plan s twelve months Your SEP to sw D plan begins the twelfth mon through the en month after yo and your Medi learns from CM that you moved ago, the plan s twelve months Your SEP to sw Medicare Adva the beginning o and continues the eighth mon You become eligible to enroll in a Part D plan or a Medicare Advantage Plan because you have: Moved back to the U.S. after living abroad You qualify for an SEP plan or a Medicare Ad have an SEP to join a or Part D plan beginni month before your mo two months after the m
edicare Advantage ermanent move have an SEP to vate health or drug onth you tell your ull months thereafter. your private health move: care Part D plan MS or the post office d over twelve months should disenroll you after your move. witch to another Part at the beginning of nth and continues nd of the fourteenth ur move. care Advantage Plan MS or the post office d over six months should disenroll you after your move. witch to another antage Plan begins at of the sixth month through the end of nth after your move. enrollment application. P to enroll in a Part D dvantage Plan. You Medicare Advantage ng as early as the ove and lasting up to move. You may choose to begin coverage any time between the first day of the month you moved (as long as you have submitted a completed application), and up to three months after your Medicare Advantage Plan or Part D plan receives the completed
© 2018 Medicare Rights Center You were released from prison (You aren’t eligible to enroll in Part D plans or Medicare Advantage Plans if you live outside the U.S. or are in prison.) 9. You have had Medicare eligibility issues. You have an SEP if… Your SEP You have received retroactive enrollment into Medicare. Your enrollment period Advantage or Part D p begins the month that your Medicare entitlem for an additional two m month the notice is rec You do not have premium-free Part A and you enroll in Part B during the General Enrollment Period (January 1 to March 31 of each year) with your Part B coverage beginning July 1. You have an SEP to jo D plan from April 1-Ju enrolled in Part B). You lost Part B but still have Part A and are involuntarily disenrolled from your Medicare Advantage Plan. You have an SEP to e Part D drug plan that b learn you lost Part B a additional months. 10. You’re eligible to join a Special Needs Plan ( You have an SEP if… Your SEP You’re eligible to enroll in a Medicare SNP. You can leave your M Plan or Part D plan a a SNP if you are eligib If you have a chronic c 10 This enrollment period serves as your initial enrollment period for Medicare dru plan within the time limits of your SEP.