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On January 1, 2019, the election periods for Medicare/Medicaid enrollees changed. Dual eligible consumers will NOT have the option of a monthly SEP due to dual status.


RULES:

  • One Dual SEP election period change per calendar quarter
  • Consumers must be dual or LIS-eligible
  • In the fourth quarter, consumers must use the AEP election (October 15 – December 7) or another election period if eligible
  • The Dual SEP may not be used to switch plans between October and December
  • The SEP is considered “used” based on the month in which the election was made

 

 

Source (SEP Specifically for Dual Eligible Beneficiaries: 20.1.1): https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/MMPInformationandGuidance/Downloads/MMPEnrollmentNationalGuidance.pdf