Dual Election Rule Changes
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