Miles is a licensed agent who represents Colgate Health and its Medicare Advantage (MA) plans. Miles has several clients who have recently come to him for help. They are in their initial coverage period9s) (ICEP) and are interested in enrolling in one of Colgate Healths MA plans. Adam will soon turn 68 and has decided to retire. Betty is about to turn 65 and has also decided to retire. Adam and Betty both currently have coverage through Colgate Health. Charles had health coverage through Colgate but dropped the coverage when he retired early to travel to Europe. Charles has just turned age 65 and is now back in the United States. Diedre, who will turn 65 next month, currently has coverage through Ditmas Health a company that Miles also represents. Who qualifies for the opt-in simplified enrollment mechanism?

a. Betty alone because she is about to turn 65 and will not have a break between her non-Medicare and Medicare coverage through Colgate Health Plan while Adams age may preclude simplified enrollment and require individual medical underwriting.

b.

Adam and Charles because each of them is 65 or over, have coverage, and in their initial coverage election period (ICEP).

c. Adam and Betty because each of them will not have a break between their non-Medicare and Medicare coverage through Colgate Health Plan.

d. Adam, Betty, and Diedre because electronic health record interoperability will allow Miles to access any needed information for their applications.

Correct Answer is

Adam qualifies for opt-in enrollment because he will not have a break between his non-Medicare and Medicare coverage through Colgate Health Plan. Charles, on the other hand, dropped his coverage with Colgate when he retired early.