DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland 21244-1850
CENTER FOR MEDICARE
_img_1.jpg)
DATE: February 7, 2011
TO: All Medicare Advantage Organizations and Prescription Drug Plan Sponsors
FROM: Anthony Culotta, Director
Medicare Enrollment & Appeals Group
RE: Extension of the Non-Renewal/Service Area Reduction Special Enrollment Period
CMS has extended through February 28, 2011, the Special Enrollment Period (SEP) for individuals affected by Medicare Advantage (MA) and Part D plan (PDP) non-renewals (NRs) or service area reductions (SARs).
In late January, individuals who were disenrolled from an MA or Part D plan on December 31, 2010 because of a plan non-renewal, but had not yet selected Part D coverage, received a notice from CMS advising them that they now have until February 28, 2011 to obtain Part D coverage. A copy of the notice is attached. Although this notice was only sent to individuals affected by an MA or PDP non-renewal, the extension of the SEP also applies to individuals who were affected by service area reductions and have not yet obtained Part D coverage.
Individuals who have already used the NR/SAR SEP to enroll in a Part D plan may not use this extension to make a new election. For the policy detailing the scope of the NR/SAR SEP, please refer to §30.4.3 of Chapter 2 of the Medicare Managed Care Manual or §30.3.4 of Chapter 3 of the Prescription Drug Benefit Manual.
The extension of this SEP in no way reduces or changes CMS’ marketing requirements. Plan sponsors are reminded that they are prohibited from engaging in direct, unsolicited contact with beneficiaries. Regardless of whether or not plan sponsors had a previous relationship with these beneficiaries, unsolicited calls to former members who have disenrolled or been disenrolled due to a non-renewal or service area reduction are prohibited. Additionally, plan sponsors are responsible for ensuring that third parties conducting marketing on behalf of the plan also adhere to these requirements.
For Assistance
If you have specific policy questions about the extension of the NR/SAR SEP, please contact Jim Canavan at (410) 786-5223 or James.Canavan@cms.hhs.gov.
¡Actué Pronto!
Se aproxima la fecha límite para obtener la cobertura de medicamentos de Medicare.
Usted está recibiendo esta carta porque nuestros archivos indican que su cobertura de medicamentos recetados de Medicare terminó el 31 de diciembre de 2010, y no se ha inscrito en un nuevo plan de medicamentos de Medicare. Este es un recordatorio de Medicare que tiene que actuar pronto si desea la cobertura de Medicare para el 2011.
Tiene hasta el 28 de febrero para obtener la cobertura de medicamentos de Medicare.
Nuestros registros indican que a partir del 17 de enero de 2011, no tendrá cobertura de recetas médicas de Medicare. Si desea la cobertura de Medicare para el año 2011, tendrá que inscribirse en un Plan de Recetas Médicas de Medicare o en un Plan Medicare Advantage con cobertura de medicamentos antes del 28 de febrero de 2011. Su nueva cobertura comenzará el mes después de inscribirse.
Qué Hacer:
Visite
www.medicare.gov
para comparar los planes de salud y medicamentos disponibles en su área, revise su manual “Medicare y Usted”, o llame al 1-800-MEDICARE (1-800-633-4227) para obtener ayuda en la elección e inscripción de un plan. Los usuarios de TTY deben llamar al 1-877-486-2048.
Aunque decida no inscribirse en un nuevo plan de salud o medicamentos de Medicare, tendrá la cobertura del Medicare Original. Su siguiente oportunidad para obtener cobertura de medicamentos recetados no será hasta el 15 de octubre de 2011 y su cobertura será efectiva el 1 de enero de 2012. Puede que también tenga que pagar una penalidad por inscripción tardía, si decide agregar la cobertura de recetas médicas de Medicare más adelante.
¡No espere! Deje que Medicare lo ayude.
Medicare ofrece ayuda e información las 24 horas al día para ayudarle a comprender sus opciones. Visite www.medicare.gov o llame al 1-800-MEDICARE. También puede llamar a su Programa Estatal de Asistencia sobre Seguros de Salud (SHIP por su sigla en inglés) para asesoramiento personalizado gratuito de seguros de salud al teléfono <SHIP number>.
Guarde esta carta. Es prueba de que tiene un derecho especial hasta el 28 de febrero 2011 para inscribirse en un Plan de Recetas Médicas o en un Plan Medicare Advantage.
See the other side for this notice in English.
<BENEFICIARY FULL NAME> HICN <1234>
<ADDRESS> January 2011
<CITY STATE ZIP>
The Deadline for Medicare Drug Coverage Is Approaching. Please Act Soon!
You’re getting this letter because our records show that your Medicare prescription drug coverage ended on December 31, 2010, and that you haven’t joined a new Medicare drug plan. This is a reminder from Medicare that you need to act soon if you want Medicare prescription drug coverage for 2011.
If you updated your Medicare drug coverage choice recently and are happy with your coverage for 2011, you can ignore this letter.
You have until February 28 to get Medicare drug coverage.
Our records show that as of January 17, 2011, you don’t have Medicare drug coverage. If you want Medicare drug coverage for 2011, you need to join a Medicare Prescription Drug Plan or a Medicare Advantage Plan with drug coverage by February 28, 2011. Joining a plan now will make sure you have coverage starting next month.
Here’s what to do next:
Visit www.medicare.gov to compare the Medicare drug and health plans available in your area. You can also see your “Medicare & You” 2011 handbook or call 1-800-MEDICARE (1-800-633-4227) to get help choosing and joining a plan. TTY users should call 1-877-486-2048.
If you decide not to join a new Medicare drug plan or health plan with drug coverage, you’ll still have Original Medicare coverage, but your next chance to get Medicare drug coverage won’t be until October 15, 2011, for an effective date of January 1, 2012. You may also have to pay a late enrollment penalty if you decide to add Medicare drug coverage later.
Don’t wait! Let Medicare help.
Medicare offers help and information 24 hours a day to help you understand your choices. Visit www.medicare.gov, or call 1-800-MEDICARE. You can also call your State Health Insurance Assistance Program for free personalized health insurance counseling at <SHIP phone number>.
Keep this letter. It’s proof that you have a special right to join a Medicare Advantage Plan or Medicare Prescription Drug Plan until February 28, 2011.
Vea al dorso para la versión en español.