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If additional documentation needed to make the enrollment request “complete” is not received within allowable time frames outlined below, the plan must deny the enrollment using the procedures outlined in § 50.4.

Example 1: Ms. Stears’ 65th birthday is April 20, 2023. She is eligible for Medicare Part A and Part B beginning April 1, 2023, and has decided to enroll in Part B beginning on April 1. Her ICEP begins on January 1, 2023, and ends on July 31. She submits an incomplete ICEP enrollment request on January 15, and the MAO requests the required, but missing, information on January 20. The enrollment request must be denied if the required information is not received by March 31.

Example 2: Ms. Mohan’s 65th birthday is June 10, 2023. She is eligible for Medicare Part A and Part B beginning June 1, 2023, and has decided to enroll in Part B beginning on June 1. Her ICEP begins on March 1, and ends on September 30. She submits an incomplete ICEP enrollment request on July 5, and the MAO requests the required but missing information on July 7. The enrollment request must be denied if the required information is not received by July 31.

50.4 – Denial of an Enrollment Request

Enrollment denials occur before the plan transmits the enrollment to CMS.

Enrollment period Information to complete request must be received: For incomplete ICEP/IEP enrollment requests received prior to the month of entitlement to Part A and/or enrollment in Part B During the first three months of the ICEP/IEP, or within 21 calendar days of the request for additional information (whichever is later)—see Example 1 below. For incomplete ICEP/IEP enrollment requests received during the month of entitlement to Part A and/or enrollment in Part B or later By the end of the month in which the enrollment request was initially received, or within 21 calendar days of the request for additional information (whichever is later)— see Example 2 below. For incomplete AEP enrollment requests: By December 7, or within 21 calendar days of the request for additional information (whichever is later). For all other enrollment periods: By the end of the month in which the enrollment request was initially received, or within 21 calendar days of the request for additional information (whichever is later).