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1132 Chapter 7:Worker guides • Section 6: MSP worker guides (07/2026) SEPs Full Dual (OHP and Medicare) Partial Dual (MSP only) LIS Only Integrated Care SEP  X X See OEP-IM-24-043 for more information on these SEPs. Annual enrollment period In October each year, CMS will announce the PDPs and MA-PDs available in the next calendar year. Enrollment for the next year’s coverage begins October 15th of each year. CMS will re-assign some individuals each year during the Annual Enrollment Period. Individuals will need to be contacted to receive choice counseling and enrollment assistance if any of the following situations applies to them: • If an individual had been auto-enrolled into their current plan and that plan will not be a LIS premium-free plan for the following year, the individual will be re-assigned by CMS into a plan that does have a full premium subsidy. • If the individual enrolled on their own or with assistance, CMS will not re-assign the individual, unless the plan is no longer serving in the area. Those individuals in plans that are increasing monthly premiums will need to either change plans or pay a monthly premium for their coverage. • If a person is enrolled in a plan that will not exist in coming year, CMS will enroll that person in a $0 premium plan. Seamless enrollment Seamless enrollment can occur when an insurance company that offers an MA-PD or SNP is already providing coverage to an individual who is not yet Medicare eligible, either through an employer, or another plan, including Medicaid. When the individual becomes Medicare eligible the plan can simply enroll that individual into their MA- PD or SNP without the need to have an enrollment form signed. The plan must send a statement to the individual giving them notice of the planned action and allow the individual to enroll into another plan. Several of the Medicaid managed care plans have made the election to enroll individuals in this manner. It is critical to work closely with the plans to ensure that individuals are not being enrolled into SNPs, when they might only be eligible for a Medicare Savings Program (QMB, SMB, or SMF) after the Medicare is established. An individual, who is later found not to be eligible for the plan, will have difficulty accessing their medications and possibly other medical services. Retroactive enrollment Medicare rules allow for all dual eligible individuals to have continuous coverage in the Medicare Prescription Drug Program. If an individual has a lapse in coverage, it is possible to get coverage retroactively. Retroactive enrollment is necessary when individuals have outstanding prescription bills or have had to pay more than the LIS level of copayments for their prescriptions. The MMA Hotline Advocates can help with retroactive plan enrollment. See MMA Problem Solving section for more information. Medicare Prescription Drug Plan coverage and exclusions