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| Medicare Advantage & Open Enrollment Begins November 15 |
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Having trouble reading this email? View it in your browser. Reminder: Medicare Advantage Annual Election, Open Enrollment and Disenrollment Periods Begin Medicare Advantage Plans are health plan options that are approved by Medicare, but are ran by private insurance companies. They are part of the Medicare Program, and sometimes called Part C . When a Medicare eligible beneficiary elects to join a Medicare Advantage Plan, the Medicare beneficiary still receives Medicare coverage; however in most cases the Medicare beneficiary must receive services from network physicians and suppliers. November 15, 2010 marks the beginning of the Medicare Advantage Annual Election Period (AEP) for Medicare beneficiaries. The annual election period occurs November 15th through December 31st of 2010. During the annual election period, Medicare beneficiaries may enroll in or disenroll from a Medicare Advantage Plan. The annual election periodis also referred to as the Fall Open Enrollment Seasonin Medicare beneficiary publications and other resource tools. If a beneficiary chooses a Medicare Advantage Plan during the annual election period (November 15 December 31, 2010), beneficiaries have the option between January 1 - February 14, 2011, to leave the plan and switch to traditional Medicare fee-for-service. The effective date of a disenrollment request made during the MADP will be the first of the month following receipt of the disenrollment request. A request made in January will be effective February 1, and a request made in February will be effective March 1. The MADP does not provide an opportunity for beneficiaries to join or switch their MA plans. Regardless of whether the MA plan included Part D drug coverage, MA enrollees using the MADP to disenroll from MA from January 1 through February 14 are eligible for a coordinating Part D Special Election Period (SEP) to enroll in a Prescription Drug Plan (PDP) and may request enrollment in a PDP during the same time frame (see §30.3.8 of Chapter 3 of the Medicare Prescription Drug Manual). An individual may use this SEP to request enrollment in a PDP subsequent to having submitted a disenrollment request from the MA plan during the MADP or may simply request enrollment in the PDP, resulting in automatic disenrollment from the MA plan. Individuals enrolled in MA-only PFFS plans must request disenrollment from the MA-only plan in order to be eligible for this SEP, as enrollment in a PDP will not result in automatic disenrollment from the MA-only plan. Note: Please refer to the CMS Internet Only Manual, Publication 100-16 Medicare Manage Care Manual for specific CMS instruction regarding the Medicare Managed Care Plans. To avoid OA-24 denials due to a Medicare Advantage Plan enrollment, suppliers are encouraged to pre-screen their new patients for Medicare Advantage Plans and re-confirm medical coverage for existing patients. The following products will provide beneficiary eligibility information:The Jurisdiction B DME MAC Interactive Voice Response (IVR) system may be accessed to verify the beneficiary s eligibility. By selection option 2 (eligibility) from the main menu, suppliers can verify the Medicare Advantage Plan number, address, telephone number and effective/termination dates. The IVR can be accessed at 1-877-299-7900 Monday through Friday, from 7:00 a.m. until 6:00 p.m. Eastern Time and Saturdays from 7:00 a.m. until 3:00 p.m. Eastern Time.The Jurisdiction B DME MAC Claim Status Inquiry (CSI) is also available to assist suppliers in confirming Medicare Advantage Plans. CSI is available from 7:00 a.m. until 6:00 p.m. Eastern Time, Monday through Friday and 7:00 a.m. until 3:00 p.m. Eastern Time on Saturdays. DMEPOS supplier enrollment information can be found on the National Government Services Web site at: http://www.ngsmedicare.com/content.aspx?CatID=3&DOCID=261The National Government Services Connex is available at www.NGSConnex.com . To sign up for Connex, view the Quick Steps Job Aid and Training Materials available on www.NGSConnex.com . To learn more about how to prevent ANSI OA-24 denials and other common claim denials, suppliers may access the Jurisdiction B DME MAC ANSI Guide located on the DME portal page on the National Government Services Web site at: http://www.ngsmedicare.com/portal.aspx?CatID=3. Remember! National Government Services' Jurisdiction B DME MAC List serv is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank You! National Government Services encourages all Web site users to provide feedback regarding ways to improve our Web site. The ForeSee Results (pop-up) survey is an easy mechanism for providers to use to let us know how we can best serve you. Your comments play a large role in the enhancements that are made to the National Government Services Web site. CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. National Government Services Inc. 8115 Knue Road | Indianapolis, IN 46250 This email was sent to: This e-mail address is being protected from spambots. You need JavaScript enabled to view it Unsubscribe Powered by MailerMailer |
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