Additional special enrollment periods
The Secretary shall establish special enrollment periods, including the following:
(A) Involuntary loss of creditable prescription drug coverage
(A)Involuntary loss of creditable prescription drug coverage#
(i) In general In the case of a part D eligible individual who involuntarily loses creditable prescription drug coverage (as defined in section 1395w–113(b)(4) of this title ).
(ii) Notice In establishing special enrollment periods under clause (i), the Secretary shall take into account when the part D eligible individuals are provided notice of the loss of creditable prescription drug coverage.
(iii) Failure to pay premium For purposes of clause (i), a loss of coverage shall be treated as voluntary if the coverage is terminated because of failure to pay a required beneficiary premium.
(iv) Reduction in coverage For purposes of clause (i), a reduction in coverage so that the coverage no longer meets the requirements under section 1395w–113(b)(5) of this title (relating to actuarial equivalence) shall be treated as an involuntary loss of coverage.
(A)(i)In general#
In the case of a part D eligible individual who involuntarily loses creditable prescription drug coverage (as defined in section 1395w–113(b)(4) of this title ).
(A)(ii)Notice#
In establishing special enrollment periods under clause (i), the Secretary shall take into account when the part D eligible individuals are provided notice of the loss of creditable prescription drug coverage.
(B)Errors in enrollment#
In the case described in section 1395p(h) of this title (relating to errors in enrollment), in the same manner as such section applies to part B.
(C)Exceptional circumstances#
In the case of part D eligible individuals who meet such exceptional conditions (in addition to those conditions applied under paragraph (1)(B)(iii)) as the Secretary may provide.
(D)Medicaid coverage#
In the case of an individual (as determined by the Secretary, subject to such limits as the Secretary may establish for individuals identified pursuant to section 1395w–104(c)(5) of this title ) who is a full-benefit dual eligible individual (as defined in section 1396u–5(c)(6) of this title ).
(E)Discontinuance of MA–PD election during first year of eligibility#
In the case of a part D eligible individual who discontinues enrollment in an MA–PD plan under the second sentence of section 1395w–21(e)(4) of this title at the time of the election of coverage under such sentence under the original medicare fee-for-service program.