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WorksheetsSEP Masters
Total questions: 15
Worksheet time: 8mins
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
Are you able to use LIS Quarter change if it has already been used but the plan is not yet in effect?
Yes, you can use it multiple times
No, once its used its gone
Yes, no exceptions
Yes, with exceptions
Where can you find the valid list of SPAP's for every state?
Discount card
Medicare.gov
The client is starting parts A & B, 05/2023 and has already used IEP for a plan that will go into effect 05/2023. Can they still change their plan and if so, how?
Yes, you can use OEP New
No, once it is used, they need another valid SEP
Yes, you can have the client cancel the application and use IEP
Yes, You can submit it and it will go into effect
There was a FEMA disaster in this clients area, what do you need to keep in mind before using DST?
Did they miss a valid SEP?
Have they changed plans since that time?
Nothing
Were they or someone that helps them effected in any way by this disaster?
Your client has Original Medicare and state Medicaid but it is SEP season. Can you enroll them into a MAPD using MDE?
Yes
No
