CMS Announces a Special Election Period (SEP) to Enroll in 5-star Medicare Advantage Plans in Plan Year 2012


Last month, Michael Crochunis (Acting Director: Medicare Enrollment & Appeals Group) released a memo to Medicare Advantage Organizations establishing a Special Election Period (SEP) for beneficiaries to enroll in 5-star Medicare Advantage Plans during the 2012 plan year.  Here is a link to the CMS memo.

Basically, this will allow Medicare beneficiaries to enroll into a 5-Star Medicare Advantage plan (during any month of the year) by using an SEP.  Below are the eligibility requirements:

Who will be eligible for this SEP?

  • Beneficiaries enrolled in MA plans with a star rating of 4.5 or less
  • Beneficiaries who are enrolled in Original Medicare and meet the eligibility requirements for Medicare Advantage

CMS is using this new SEP as an incentive for more plans to achieve the 5-Star level.  Earlier this year, a Kaiser Family Foundation report found only a small percentage of Medicare Advantage Plans had reached the 5-Start level.  Here is link to a previous blog post that includes CMS Star ratings for each company.

Hopefully, we will see additional 5-Star Medicare Advantage plans for 2012.  If so, insurance agents will be able to sell high quality Medicare Advantage plans year round. 

And that is great news!

4 Responses to CMS Announces a Special Election Period (SEP) to Enroll in 5-star Medicare Advantage Plans in Plan Year 2012

  1. J.T. Horvath says:

    Does any Medicare Advantrge plan currently being marketed even have a Five star rating? My experience helps me appreciate that the longer the plan is being offered in the market place,the lower the rating.
    (This is largely due to the increasing amount of complaints received by CMS against the plan)

    How do we prevent this decrease in rating, and or reverse adverse ratings?

  2. Karen says:

    The ratings are a joke!!!!! I’ve seen that some plans that are total junk have higher ratings. I think it’s because there is no one in the plans to complain things aren’t going correctly. And, if people complain because of their ignorance and the plan gets a lower rating that is simply not fair to the plan. (If you’ve sold MA/MAPD/PDP you know you can tell them EVERYTHING and they still will complain and say they didn’t know or they forget – again – how is that fair?)

    That’s my 2 cents.

  3. Actually, I don’t think the stars have that much to do with complaints made against a plan. CMS gives the star rating, and I believe that CMS wants plans to spend money for things like vaccines, well-health items. If a plan supports the healthy life style, offering Silver Sneakers or such and pays for flu shots; that gets the plan higher star ratings.

    I have noticed that Medco drug plan has 5 star rating. I have not discovered the MA plan with 5 stars yet, no clue who that is.

    My idea of the AEP is that it should anticipate the volume of baby boomers and realize we as agents can not kill ourselves to enroll everyone within short 6 wks. Wish someone could get the message to CMS, Medicare Beneficiaries should have annual individual enrollments based on their birth months. This would levelize the volume and allow agents to work the entire year at a decent pace and give more attention to the total needs of this client base.

  4. James T Reynolds says:

    If you are qualified for medicare via disability or age 65 with A & B. The plans offered by private insurance companies are available. HOWEVER, if you are a Vet. and you go to the Va and have copays and medical cost the Va and Medicare will not cross bill each other. So, You are a Vet with limited Va medical care or a citizen with an Advantage Plan. So, Star ratings do noting for the Real American and is a complete joke. I am looking for support to make a Vet an actual citizen with full Medicare benefits so maby we can get the type of freedom and conveniences we were risking our lives for.
    What do you think a Senator or whoever will take the bull by the horn instead of the tail and get this handled?

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