SEP Masters

Can you use OCC from MA plan to MA plan?

• Yes

• No

What SEP do you use for Loss/Change of Medicaid?

• MDE

• MCD

• NLS

Can you use the 5 Star SEP to enroll in a MAPD/MA If they currently have original Medicare?

• Yes

• No

What SEP do you use for Quarterly change of LIS and/or Medicaid?

• MDE

• MCD

• NLS

What plan code is used for Employer sponsored plans in Marx?

• Plan that starts with X

• Plan code ending in 200

• Plan code ending in 800

• Plan that starts with S

What SEP do you use for Gain, Loss or Change in LIS?

• MDE

• MCD

• NLS

Your client thought they had been diagnosed with a heart condition but was denied for a CSNP plan. Are they now stuck without coverage?

• No, Use LEC to enroll them into a regular MAPD

• Yes, unfortunately we will need to wait until AEP

• No, Use CHR to enroll them into a regular MAPD

• Start looking for SPAP's

How do you know if a plan was passively assigned by the state? (SEP Code DIF)

• Plan code starts with "X"

• Plan code starts with "H"

• Plan code starts with "S"

• Plan code starts with "R"

Can you use the Medicaid SEP on Non-Dual plans?

• Yes

• No

Your Client is new to Medicare but their plan just started this month, can you still change them to a different plan?

• No, will need to wait for AEP

• Yes, OEP NEW

• Yes, ICEP