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Auto-enrollment and facilitated enrollment are enrollment mechanisms used by CMS to enroll eligible individuals (i.e., full-benefit dual-eligibles and other LIS eligible individuals) who have not elected a Part D plan into an MA-PD (from an MA-only plan) or PDP so that they have prescription drug coverage. The primary differences between the two are the populations and the enrollment effective date.

Auto-Enrollment: Auto-Enrollment applies to only full-benefit dual eligibles. Full-benefit dual eligible individuals are: • Eligible for comprehensive Title XIX Medicaid benefits, and • Eligible for Medicare Part D.

This includes individuals who are eligible for comprehensive Medicaid benefits plus Medicaid payment of Medicare cost-sharing (sometimes known as QMB-plus or SLMB-plus).

This excludes full-benefit dual eligibles who: • Live in any of the five U.S. territories; • Live in another country; • Are incarcerated, as defined in § 10; • Are not lawfully present in the U.S.; • Have opted out of auto-enrollment into the Part D benefit; • Are not eligible to enroll in a PDP because they are enrolled in a Medicare Advantage plan, other than an MA PFFS plan that does not offer Part D or an MSA plan. • Are enrolled in a § 1876 cost plan that offers a Part D optional supplemental benefit. • Are enrolled in an MA-PFFS plan and are already enrolled in a stand-alone PDP; • Are individuals for whom an employer or union is claiming the retiree drug subsidy; or are enrolled in an employer-sponsored MA-only plan, including MA-only “800 series” plans.

Part C Policy: Under auto-enrollment, full-benefit dual eligible individuals in MA-only plans are enrolled by the MAO into an MA-PD plan unless they opt out. Full-benefit dual eligible individuals to be auto-enrolled include those who are: • Full-benefit dual eligible upon initial enrollment into an MA-only plan; and, • Existing Medicare enrollees of an MA-only plan who become newly eligible for Medicaid.

Part D Policy: Full-benefit dual eligible individuals enrolled in Original Medicare, an MSA plan, or an MA PFFS plan that does not offer Part D who have not elected a Part D plan are auto-enrolled into a PDP by CMS.