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entitlement using the Batch Eligibility Query (BEQ) process or MARx online query (M232 screen) for all enrollment requests, except enrollment requests from a current enrollee of a plan who is requesting enrollment into another plan offered by the same organization or sponsor with no break in coverage (i.e., “switching plans”).

Individuals are not required to provide evidence of entitlement to Medicare Part A and/or enrollment in Part B with their enrollment request. If the systems (BEQ or MARx online query) indicate that the individual is entitled to Medicare Part A and/or enrolled in Part B, then no further documentation of Medicare entitlement from the individual is needed. CMS systems are updated within two business days of SSA processing new or changed Part A or Part B entitlement for a Medicare beneficiary. The CMS systems are the most up-to-date data regarding Medicare entitlement for the beneficiary.

At the time CMS first receives entitlement information for a new beneficiary, the Medicare Number will also be assigned for that individual. In the event that the enrollment request does not include the Medicare Number and the plan is unable to locate the individual in the BEQ or MARx online query, the plan should consider the enrollment request incomplete.

The individual may provide the Medicare Number to the plan verbally or in writing. Examples of possible documents the beneficiary may send to the plan which outline the Medicare Number (and entitlement information) include: • Medicare card; • Medicare Award notice from SSA (shows Medicare entitlement dates only); • Benefit Verification notice from SSA (includes Medicare Number and entitlement start dates); • Medicare card information from the individual’s MyMedicare.gov account; and • A notice from CMS regarding change in Medicare Number.

NOTE: If the beneficiary provides any of the notices listed above, the date on the letter should be no more than two months before the enrollment request was received by the plan. If there is a discrepancy between the entitlement information in a document and the information in CMS’ systems, use the data in CMS systems to determine eligibility for enrollment.

• Effective Date of Coverage – The plan must determine the effective date of coverage for all enrollment requests. If the individual fills out an enrollment form in a face-to-face interview, then the plan representative may advise the individual of the proposed effective date; however, in order to provide individuals in this situation with accurate and complete information about their election, a plan representative should at the same time disclose that it is only a proposed effective date and that the individual will hear directly from the plan to confirm the actual effective date. The plan must notify the individual of the effective date of coverage prior to the effective date.

With the exception of some SEPs and when election periods overlap, individuals may not choose their effective date. Instead, the plan is responsible for assigning the appropriate