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Individual enrolled in: Ability to have a separate stand-alone PDP: MA coordinated care plan with Part D coverage (MA-PD plan) No MA coordinated care plan without Part D coverage (MA-only plan) No MA Private Fee-for-Service (PFFS) plan without Part D coverage Yes (person can choose a stand-alone PDP, even if the organization offers another MA PFFS plan with Part D coverage) MA PFFS plan with Part D coverage No Medicare MSA plan Yes Medicare cost plan Yes Original Medicare Yes

Part C Policy: Employer Group Waiver Plans (EGWP) with CMS approval may offer enrollment into an MA- only plan and a stand-alone PDP for its enrollees. See Chapter 9 of the Medicare Managed Care Manual for more information.

Part D Policy: Individuals enrolled in Medicare cost plans may enroll in Part D coverage through a Medicare cost plan’s optional supplemental Part D benefit or join a separate, stand-alone PDP.

20.2 – Entitlement to Medicare Parts A and B 42 CFR §§ 422.50 and 423.30

To be eligible to enroll in an MA or Part D plan, the individual must be entitled to/eligible for and enrolled in: • Part A and B—for enrollment into MA plan (including MA-PD plan) • Part A or Part B (or both)—for enrollment into a stand-alone Part D plan

The individual’s Part A and/or Part B coverage must be in effect as of the date the plan’s coverage starts.

Part C Policy: There are limited exceptions to the requirement that individuals have both Part A and B coverage to enroll in an MA plan. See Chapter 9, Medicare Managed Care Manual, and § 20.2.1 below for more information on the enrollment of Part B-only individuals.

20.2.1 – Grandfathering of Members on January 1, 1999 42 CFR § 422.50