Enrollment Details

Medicare Enrollment Dates, Deadlines, and Helpful Details

Medicare Enrollment Periods

Annual Election Period (AEP): October 15 – December 7

Eligible individuals may enroll in or change Medicare Advantage plans. Coverage will be effective January 1. You will receive acknowledgement letters from CDPHP when your application is processed, along with a confirmation letter and ID cards when your application is approved by the federal government. You may enroll in only one Medicare Advantage plan at a time, and you may join or leave that plan at certain times of the year or in special circumstances.

• Medicare HMO Plan Election Change Form

• Medicare PPO Plan Election Change Form

• Western NY Medicare PPO Plan Election Change Form

Medicare Advantage Open Enrollment Period (OEP): January 1 - March 31

I enrolled in a Medicare Advantage plan during AEP. What can I change?

• You may change from one Medicare Advantage plan to another.

• You may leave your Medicare Advantage plan and go back to Original Medicare Part A and Part B – with or without prescription drug coverage (Part D).

• You may enroll in a prescription drug (Part D) stand-alone plan.

I have Original Medicare. Can I change my Part D plan or enroll in a Medicare Advantage plan?

• Unfortunately, not during OEP. You can make those changes during 2020 AEP which starts October 1.

Special Enrollment Period (SEP)

If you would like to enroll in a CDPHP Medicare Advantage plan outside the annual election period, you may qualify for a Special Enrollment Period. Please indicate which Special Enrollment Period you qualify for on the application and fax it to (518) 641-4606. Or mail it to:

CDPHP Medicare Sales
500 Patroon Creek Blvd.
Albany, NY 12206-1057

If you aren't sure if you qualify for a SEP, please contact our sales department at (518) 641-3400.

Medicare Advantage Disenrollment (Leaving the Plan) Rights and Responsibilities

"Disenrollment" means ending your membership in CDPHP Medicare Advantage plans. You can choose to return to Original Medicare and will need to select a separate Medicare prescription drug plan. Your new plan coverage will begin on the first day of the month after we receive your request.

You may not enroll in a new plan during other times of the year unless you meet certain exceptions, such as moving out of the plan’s service area, joining a plan in your area with a 5-star rating, or qualifying for extra help with your prescription drug costs.

Upon disenrollment, you will receive a letter confirming your request, information about Medigap rights (if returning to Original Medicare), and the date your plan coverage will end. You must continue to receive all medical care from CDPHP participating providers until the date noted. We will notify you if Medicare denies your disenrollment request.

If your new plan does not include creditable prescription drug coverage (coverage that is at least as good as Medicare’s), you may pay a penalty if you join a Medicare drug plan later.

CDPHP must end your membership in our plan in certain situations:

• If you do not stay continuously enrolled in Medicare Part A and Part B

• If you move out of our service area

• If you are more than 90 days behind in your premium payment

• If you are required to pay the extra Part D amount to Medicare because of your income and you do not pay it

Please refer to your Evidence of Coverage for more information. If we end your membership, we will send you our reasons in writing. We cannot ask you to leave our plan for any health-related reason.

If you have questions, please call member services at 1-888-248-6522 (TTY/TDD: 711). Our hours are 8 a.m. – 8 p.m. seven days a week, October 1 – March 31. From April 1 to September 30, Monday – Friday, our hours are 8 a.m. to 8 p.m. A voice messaging service is used weekends, after-hours, and federal holidays. Calls will be returned within one business day.

Enroll through CMS

Medicare beneficiaries may also enroll in a CDPHP Medicare Advantage plan on medicare.gov. Select "Find Plans Now" to begin your search. For more information, contact CDPHP Medicare Advantage member services.

Additional Help for Low-Income Beneficiaries

You may be able to get extra help* to pay for your prescription drug premiums and costs. To see if you qualify, call:

• 1-800-MEDICARE (1-800-633-4227). TTY/TDD: 711, 24 hours a day/7days a week

• The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD: 711

• Your state Medicaid office.

You may wish to view the Low Income Subsidy Premium Summary Table for Those Receiving Extra Help. This document informs potential enrollees of what their plan premium will be once they are eligible and receive the low-income subsidy.

*People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for 75 percent of drug costs, including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. If you think you qualify for extra help with your prescription drug costs but you don’t have or can’t find proof, please read the CMS Best Available Evidence (BAE) policy.

Medicare Advantage Contract Termination

Each year, CDPHP decides whether to stay in the Medicare program for another year. If we choose not to continue, we must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area, and your options will always include Original Medicare. All the benefits and rules you had under CDPHP will continue until your membership with CDPHP ends.

CDPHP is a health plan with a Medicare contract. Enrollment in CDPHP Medicare Advantage depends on contract renewal. To join, you must have Medicare Parts A and B and live in the service area.