Monthly enrollment option introduced for beneficiaries with dual coverage under Medicare and Medicaid
New Monthly Enrollment Option Offers Flexibility to Medicare Beneficiaries
Starting January 1, 2025, a significant change is coming for dual eligible beneficiaries and Low-Income Subsidy (LIS) recipients. The Centers for Medicare and Medicaid Services (CMS) has introduced a new monthly enrollment option, providing these individuals with more flexibility to adjust their prescription drug coverage as their needs change.
This new option replaces the quarterly Dual/LIS Special Enrollment Period (SEP). Previously, dual eligible beneficiaries, who are enrolled in both Medicare and Medicaid, and LIS recipients could only change their prescription drug plans once per quarter during the first nine months of the calendar year.
The new monthly enrollment option offers up to 12 opportunities a year for eligible individuals to enroll in a standalone Prescription Drug Plan (PDP) or leave a Medicare Advantage (MA or MAPD) plan and return to Original Medicare with a PDP. This means that eligible individuals can make one plan change per month, all year long.
For those who may need assistance understanding these changes, the State Health Insurance Assistance Program (SHIP) offers a medicare counseling service. SHIP explains the changes in the monthly enrollment period for dual eligibles and LIS recipients and helps mediate suitable Medicare plans.
This new development is expected to bring a sense of relief to many dual eligible beneficiaries and LIS recipients, offering them greater control over their prescription drug coverage and the ability to adapt to changing circumstances more easily.
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