Welcoming the CY 2021 Enrollment Guidance updates header image

Welcoming the CY 2021 Enrollment Guidance updates

By Lynn Holland, Vice President

It’s here!  CMS dropped the long-anticipated Medicare Advantage and Prescription Drug Plan enrollment updates via HPMS memorandum on August 11, 2020. With these updates, CMS unveiled the new standardized enrollment form, made necessary changes throughout to reflect the ability of those with ESRD to enroll in MA plans effective 1/1/21, provided a few new and updated Special Election Periods (SEPs), and allowed plans to utilize true e-signatures with electronic enrollments. Welcoming the CY 2021 Enrollment Guidance updates header image

The enrollment form update is the biggest change in this year’s guidance. The newly streamlined form includes a cover page, separates information into  “required” vs. “optional” sections, and significantly streamlines all of the narrative content from the prior form, resulting in a succinct set of statements under “Important – read & sign below section.” The “standardized” enrollment form was the outcome of a formal request by CMS for public comment on proposed changes. Another plus for plans is while this new version is a “standardized” model, CMS will permit plans to create customizations, if desired.  All MA and Part D plans are expected to use this version (or modifications to this version) starting with the upcoming AEP.

We also see the addition of two new SEPs in the guidance that were released in the final rule earlier this year – one for individuals enrolled in a plan placed into government receivership and the other for those in a plan classified by CMS as a consistently poor performer.  While not mentioned in the memo, we see an update to the FEMA SEP that was described in the final regulation, now the “SEP for Government Entity-Declared Disaster or Other Emergency.”  This SEP expands the prior SEP to include disaster or other emergency declared by a Federal, state or local government entity. CMS also added a more general SEP to handle very unusual case-by-case situations.

To see the changes discussed above, the final enrollment form, and the HPMS memo announcement, check out CMS enrollment websites:

https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/index

https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicarePresDrugEligEnrol/index

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