Reference Information for Answers

Question 1.  A press release from CMS on March 20, 2006 announced that the effective date for facilitated enrollment is May 1, 2006 (moved up from June 1, 2006).

Question 2.   Section 20.3.8 (8) of CMS' Operational Guidance for Enrollment and Disenrollment addresses the topic of Special Enrollment Periods for those facilitated enrolled into Part D plans:

8. SEP for Other LIS Eligible Individuals Who are Not Dual Eligible Individuals Whose Part D Enrollment is Facilitated – If CMS facilitates enrollment for Other LIS Eligible individuals (who are not dual eligible individuals) into a PDP plan, the individual has an SEP to change to a different PDP. The SEP begins with the effective date of the facilitated enrollment, and ends on December 31st of the same year.

Question 5.  Section 423.46 of the MMA Regulations defines the population affected by the late enrollment penalty:

(a) General.  A Part D eligible individual must pay the late penalty described under § 423.286(d)(3) if there is a continuous period of 63 days or longer at any time after the end of the individual's initial enrollment period during which the individual meets all of the following conditions: (1) The individual was eligible to enroll in a Part D plan; (2) The individual was not covered under any creditable prescription drug coverage; and (3) The individual was not enrolled in a Part D plan.

Question 7.  The continuous SEP for full duals was established in Section 423.38 (c)(4) of the MMA Regulations:

(c) Special enrollment periods. A Part D eligible individual may enroll in a PDP or disenroll from a PDP and enroll in another PDP or MA-PD plan (as provided at § 422.62(b) of this chapter), as applicable, at any time under any of the following circumstances:[…]

(4) The individual is a full-benefit dual eligible individual as defined under section 1935(c)(6) of the Act.

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