5-Star SEP

1. 5-Star SEP • December 8 - November 30 • Join or switch to 5-Star MA plan (with or without drug coverage) or 5-Star PDP in service area • Can only be used to enroll in plans given an overall 5-star rating for the current calendar year

2. 5-Star SEP • Individuals must be otherwise eligible to enroll in plan • Plans may accept enrollment requests from December 8 through November 30 • Effective dates are first of month following enrollment request – MUST match timing when plan has 5-Star rating (January – December) • Star rating on Plan Finder, not M&Y

3. 5-Star SEP Individuals can also join a 5-star cost plan • SEPs don’t apply to cost plans • 5 Star SEP allows disenrollment from MA plan to enroll in 5-star cost plan • SEP doesn’t allow enrollment in cost plan’s optional supplemental Part D benefit (but see upcoming slide)

4. 5-Star SEP • Beneficiaries can only use SEP one time during the year • No guarantee of drug or MA coverage • MAPD  MA only = no drug coverage • PDP  MA only = no drug coverage* • MAPD  PDP = no MA coverage (but will still have Original Medicare) * But see next slide

5. 5-Star SEP Coordinating Part D SEP • If standalone PDP is allowed, can join for same month • PDP doesn’t have to be a 5-star plan • Can also join the optional supplemental Part D benefit of a cost plan if enrolling in a 5-star cost plan

6. Reminder - MADP Medicare Advantage Disenrollment Period • Going on right now through February 14 • Individuals enrolled in an MA plan can disenroll • Go back to Original Medicare • If disenrolling, can pick up a PDP • If leaving an MA-only PFFS plan with separate PDP, cannot change PDP