If a beneficiary enrolled in an MA-only plan during the Annual Election Period, when can they enroll in a plan that offers prescription drug coverage?

A beneficiary enrolled in a Medicare Advantage (MA) only plan during the Annual Election Period (AEP) has the opportunity to switch to a plan that offers prescription drug coverage during a Special Election Period (SEP). This is important because SEPs are designed to provide flexibility for beneficiaries who may have specific circumstances that warrant a change in their coverage outside of the standard enrollment periods.

Examples of such circumstances include moving to a new location, losing other creditable prescription drug coverage, or experiencing other qualifying events that allow a beneficiary to enroll in a plan that suits their needs better. Since prescription drug coverage is not included in MA-only plans, the SEP allows beneficiaries to integrate necessary prescription coverage without having to wait until the next AEP, thereby ensuring they have timely access to needed medications.

The other options presented do not provide the same flexibility or do not align with the regulations that govern Medicare enrollment periods. Thus, the ability to utilize a Special Election Period is the correct pathway for a beneficiary wishing to enroll in a plan with prescription drug coverage after initially signing up for an MA-only plan.