How do I get more information and enroll?
Enrolling in Medicare in a Medicare Advantage Plan is easy. Call us at 1-360-687-3002, or 206-922-2424 for a free Medicare Advantage quote and consultation. We can answer your questions and handle your enrollment over the phone and mail or personally deliver an application to you if you wish.

What is Open-Enrollment?
Open-Enrollment, also known as the Initial Coverage Election Period ICEP (not to be confused with the Initial Election Period IEP for Medicare Part D) is a one-time event when an individual first has the opportunity to enroll in a Medicare Advantage (MA) plan. It occurs for most people when turning age 65 and enrolling in Medicare Parts A & B for the first time. For people turning 65 the ICEP (first time enrollment period) lasts seven (7) months: it begins three (3) months prior to your birth month, includes your birth month, and extends three (3) months after your birth month. In addition, people of any age enrolling in Medicare Part B for the first time may enroll in a MA Plan three months prior to their requested effective date for Part B, during the month of their Part B effective date as well as three months after their Part B effective date. Coverage becomes effective on the first day of the month after your enrollment.

What is the Annual Coordinated Election Period (ACEP)?
The Annual Election Period for coverage effective in 2007 begins November 15, 2006 and ends December 31st, 2006. During this period each, anyone who is enrolled in Medicare may enroll for the first time in an MA plan; or change from one MA plan to another; or return to Original Medicare from an MA plan. If during this period you enroll in an MA plan that includes Medicare Part D prescription drug coverage then any prior Medicare Part D Plan coverage is automatically cancelled and replaced by the new MA plan with prescription drug coverage -- these plans are known as MA-PD plans (Medicare Advantage-Part D plans). Enrollments during this period have an effective date of January 01, 2007. The ACEP occurs November 15 through December 31 of every year.

The Initial Enrollment Period for Part D mirrors that of the ACEP for Medicare Advantage. The preamble to the federal regulations states that, notwithstanding the special election periods discussed below, it is only during the ACEP that all Medicare beneficiaries are free to elect among all available options, whether original Medicare, MA plans, MA-PD plans or Medicare Part D plans (PDPs). This is because permitting a beneficiary to discontinue Part D coverage at any time during the year, without a corresponding election period to enroll in such coverage, could result in a gap in coverage that may result in a late enrollment penalty.

What is a Special Election Period (SEP)?
A Special Election Period means that you are allowed to enroll in Medicare Advanatge after the ICEP and/or ACEP because you meet certain conditions set forth by the government. Below are the specific situations which might qualify you for a SEP.

You may qualify for a Special Election Period if:

• You are a Hurricane Katrina evacuee and reside in certain zip codes as identified by the Federal Emergency Management Agency at the time of the hurricane (August 2005).
• You move permanently outside your plan's service area.
• You're enrolled in another prescription drug plan or a Medicare Advantage plan whose contract is terminated.
• You lose your previous creditable coverage through no action of your own*.
• Your enrollment or non-enrollment is caused by an error by a federal employee or contractor hired by the federal government.
• You were eligible for both Medicare and Medicaid (a “dual eligible”) but you lost your dual eligibility status.
• You want to move from an employer-sponsored prescription drug plan to a Medicare Prescription Drug Plan.
• You want to leave your current Medicare Prescription Drug Plan because it was reprimanded by the federal government or the federal government has determined the plan violated a material provision of its Medicare contract in relation to services provided to you.
• You’re enrolled in a Cost Plan that isn’t renewing its contract with Medicare. This SEP begins 90 calendar days prior to the end of the contract year (i.e., October 1) and ends on December 31 of the same year.
• You want to move from a Program of All-Inclusive Care for the Elderly—PACE—to an MA-PD.
• You live in—or are moving in or out of—a skilled nursing facility, nursing facility, intermediate care facility for the mentally retarded, psychiatric hospital or unit, rehabilitation hospital or unit, long-term care hospital or swing-bed hospital.
• Your Medicare entitlement determination is made retroactively
• You are not eligible for premium free Part A and enroll in Medicare Part B during the January-March 2007 Part B General Enrollment Period.
• You have a low-income subsidy.
• The federal government may authorize other special election periods.

Can I change my Medicare Advantage plan after I enroll?
Once enrolled in an MA or MA-PD Plan you can change your plan once between January 01 to March 31 of each year. If you want to change plans again you must wait until the next Annual Coordinate Election Period (ACEP) November 15.

What is the Open Enrollment Period (OEP)?
During the Open Enrollment Period (OEP) January 01 - March 31 an individual has the opportunity to make an MA election. During an OEP MA organizations are not required to open their MA plans for enrollment. However, because Original Medicare is always open during an OEP, an MA organization must accept valid requests for disenrollment during the OEP. For 2007 and future years, an MA eligible individual may make one MA OEP election during the first 3 months of the year. A change of election made during an OEP is limited to the same type of plan in which the individual making the election is already enrolled. For example, an individual who is enrolled in an MA-PD plan may elect another MA-PD plan or disenroll from the MA-PD by enrolling in Original Medicare with coverage under a PDP. An individual who is in Original Medicare and is enrolled in a PDP may elect an MA-PD. However, the individual may not elect an MA plan that does not provide qualified prescription drug coverage.

An MA-eligible individual who is institutionalized, as defined by the Centers for Medicare & Medicaid Services (CMS), can make an unlimited number of MA elections during the OEP. Subject to the MA plan being open to enrollees an MA-eligible institutionalized individual may at any time elect an MA plan or change his or her election from an MA plan to original Medicare, to a different MA plan, or from original Medicare to an MA plan.

Some categories of beneficiaries are not bound by the lock-in rules and may enroll or disenroll from an MA plan in other than the ACEP or OEP. An individual may at any time, during a designated Special Election Period (SEP), discontinue the election of an MA plan offered by an MA organization and change his or her election to original Medicare or to a different MA plan. Examples of situations which may entitle an individual to an SEP include the termination or discontinuation of a plan, a change in residency out of the service area, the organization violating a provision of a contract or misrepresenting the plan’s provisions, or the individual meeting other exceptional conditions as CMS may provide. CMS has also designated an SEP for individuals entitled to Medicare A and B and who receive any type of assistance from Title XIX (Medicaid), including full-benefit dual eligible individuals, as well as those eligible only for the Medicare Savings Programs. This SEP lasts from the time the individual becomes dually eligible until such time as they no longer receive Medicaid benefits. Individuals who are eligible for an SEP under the guidance for Part D enrollment and disenrollment may use that SEP to also make an election into or out of an MA-PD plan.

Important Medicare Advantage Dates to Remember
 

November 15, 2006
Annual Coordinated Election Period begins. First day you may elect to enroll in a 2007 Medicare Advantage Plan if you were not previously eligible for ICEP. The plan effective date will be 01 January 2007.

December 31, 2006
Last day you can enroll in a Medicare Advantage Plan , if you are opting into Part D for the first time, unless you qualify for an exception.

January 1, 2007
First day your 2007 Medicare Advantage plan is effective. Open Election Period begins, allowing you to switch to another "like" plan type as far as Part D drug coverage. If your current plan includes Part D drug coverage, then your new plan must also. If you don't already have Medicare Part D coverage then you cannot switch to a Medicare Advantage plan that includes Part D drug coverage.

March 31, 2007
Open Election Period ends. Last day you can switch from one "like" Medicare Advantage Plan to another (MA to MA or MA-PD to MA-PD); or from Original Medicare to a Medicare Advantage Plan; or from a Medicare Supplement to a Medicare Advantage Plan. If you don't already have Medicare Part D coverage then you cannot switch to a Medicare Advantage Plan that includes Part D coverage.