Answered

Mr. White has Medicare Parts A and B with a Part D plan. Last year, he received a notice that his plan sponsor identified him as a “potential at-risk” beneficiary. This month, he started receiving assistance from Medicaid. He wants to find a different Part D plan that’s more suitable to his current prescription drug needs. He believes he’s entitled to a SEP since he is now a dual eligible. Is he able to change to a different Part D plan during a SEP for dual eligible individuals?

Answer :

Answer:

yes

Explanation:

Duals have sep every Quater, but is you are new to medicaid that is another sep

Mr White cannot  change to a different Part D plan.

  • Special Enrollment Period is a period of time when a person is able to sign up for health insurance. During this period,  such person can make changes to their Medicare Advantage when some things happen in their lives such as getting married or having a baby.

  • Following the information given in the question, Mr White cannot change to a different Part D plan during a SEP for dual eligible individuals.
  • The reason for this is because he has been identified as a potential at risk beneficiary by the plan sponsor. Therefore, due to this, he cannot be able to use the dual eligible SEP in the changing of plans.

In conclusion, No. He cannot change to a different Part D plan during a SEP for dual eligible individuals.

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