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Part D Policy: When the Part D sponsor learns from CMS or the U.S. Post Office (as described in § 60.2.1) that the individual has been out of the service area for over 12 months and the individual is disenrolled because the sponsor has not been able to confirm the residency status of the individual, the SEP for that individual begins the first day of the 12th month and ends the last day of the 14th month of the individual’s absence from the service area.

Example 1: In May, an individual notifies their MA plan in Florida that they intend to move to Arizona on June 18. An SEP exists for this individual from May 1 to August 31.

A. If the MAO receives the enrollment request from the individual in June (the month of the move), the individual can choose an effective date of July 1, August 1, or September 1.

B. If the MAO receives the enrollment request in July, the individual could choose an effective date of August 1, September 1, or October 1.

C. If an MAO in Arizona receives an enrollment request from the individual in August, the individual can choose an effective date of September 1, October 1, or November 1.

Example 2: An individual resides in Florida and is currently enrolled in Original Medicare but is not enrolled in a PDP. The individual intends to move to Maryland on August 3 and wants to enroll in a PDP. An SEP exists for this individual from July 1 through October 31.

At the time the individual requests enrollment in an MA or Part D plan, the individual must provide the specific address where they will permanently reside upon moving into the service area, so that the sponsor can determine that the individual meets the residency requirements for enrollment in the plan.

30.6.21 – SEP for individuals who are enrolled or not enrolled in Part D due to an error by a federal employee 42 CFR §§ 422.62(b)(21) and 423.38(c)(3)

An individual whose enrollment or non-enrollment in a Part D plan, including an MA-PD plan, was erroneous due to an action, inaction, or error by a federal employee is eligible to enroll in or disenroll from the Part D plan, as determined by CMS on a case-by-case basis.

This SEP begins the month that CMS approves the SEP and ends two calendar months after the month of the approval.

30.6.22 – SEP for individuals who want to enroll in a 5-star plan 42 CFR §§ 422.62(b)(15), 423.38(c)(20), and 423.38(c)(29)

This SEP allows individuals to enroll in an MA plan or Part D plan with a Star Rating of 5 stars for an effective date during the year in which that plan has the 5-star overall rating, provided the