Important Enrollment Information

• Enrollment Eligibility
• Enrollment Periods
• Switching Plans
• Creditable Coverage

Enrollment Eligibility
To be eligible for enrollment in Blue MedicareRx, enrollees must:

• Be entitled to Medicare Part A and/or enrolled in Medicare Part B;
• Reside in the state of Illinois; and
• Not be enrolled in another Medicare Part D plan at the same time as Blue MedicareRx.

Enrollment Periods
Eligible Medicare beneficiaries may only enroll in Blue MedicareRx during specific times of the year known as enrollment periods or election periods.

• Initial Enrollment Period (IEP)
  This is a seven (7) month period consisting of:
  • three (3) months before the month of your clients 65th birthday
  • the month of your clients 65th birthday
  • three (3) months after the month of your clients 65th birthday

  Those who are under age 65 and have a disability may also be eligible to enroll.

• Annual Enrollment Period (AEP)
  Your clients can enroll in Blue MedicareRx between November 15th and December 31st, which is commonly referred to as the Annual Enrollment Period. If they are enrolled in another Medicare Part D plan, they may also switch to Blue MedicareRx during this period.
• Special Enrollment Period (SEP)
  Your clients may also enroll in Blue MedicareRx outside of the initial or annual enrollment periods under circumstances such as (but not limited to):
  • moving into the service area
  • involuntarily losing creditable coverage
  • becoming dual eligible

Switching Plans
Once a year, Medicare Part D members may:

• Switch from one health insurance plan to another or
• Switch between plans offered by their current health insurance plan (i.e. Blue MedicareRx Value to Blue MedicareRx Plus).

A plan switch generally occurs during the Annual or Special Enrollment Period.

Creditable Coverage
Medicare eligible beneficiaries may choose not to enroll in Blue MedicareRx if they have what is considered creditable coverage - prescription drug coverage that is equal to or greater in value to the standard Medicare prescription drug coverage  and includes the following examples:

• Group Health Plan for Retirees (through a current or former employer);
• State Pharmacy Assistance Program (SPAP);
• Veteran’s Affairs (VA) Program; and
• TRICARE.

This list is not all inclusive nor does it imply that all of these examples automatically qualify for creditable coverage.

Medicare-eligible beneficiaries should receive notification from the respective organization if they in fact have creditable coverage. If they don’t receive notification, but are covered under one of these plans, they should contact the respective organization directly to confirm if creditable coverage exists.