Top 5 CMS changes for 2021

Top 5 CMS changes for 2021

With AEP in full swing, take a look at the top 5 CMS changes for 2021.

People with End-Stage Renal Disease are eligible to enroll in a Medicare Advantage Plan.

At the beginning of 2021, people with ESRD are allowed to enroll in a Medicare Advantage plan. That is also going to eliminate the Special Enrollment Period for individuals with ESRD, as it will be a standard eligibility requirement from January 1 and beyond. Another significant change for the 2021 Automatic Enrollment Period. The SEP will be retired for people with ESRD wanting to sign up for Medicare on December 31 of 2020, when it switches to being a standard requirement. major

Special Enrollment Period added for natural disasters.

Beginning in 2021, a Special Enrollment Period will be available for individuals impacted by a weather-related incident or other major disasters. Previously, this SEP was limited to people impacted by a FEMA declared disaster. The SEP will begin on the earlier of two days: the day of the declaration, or the date identified as a start date in the declaration. The SEP will last two calendar months following the end date of the declaration or the end date stated in the declaration, whichever date comes later. 

New Special Enrollment Period for those Enrolled in a Plan that is classified by CMS as a Consistent Poor Performer

CMS classifies a plan as a poor performer if it has received below a three-star rating in the last three years. This SEP is available at any time of the year if someone enrolls in a poor-performing plan. As usual, the SEP would last two months from the start date.


New Special Enrollment Period for people Enrolled in a Plan Placed in Receivership

Receivership is when a health plan gives an independent party (the receiver) to make business decisions for the plan. Typically, related to financial difficulties, such as not being able to pay loans back. The receiver could be appointed privately, through government regulation, or court-appointed.

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We hope this information on Top 5 CMS changes for 2021 is helpful. 

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