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Annual enrollment choice is a two-month process. An Annual Enrollment Notice is mailed to the customer or representative approximately two months prior to the customer’s anniversary date.
The first month is the customer’s choice month. During this month the customer has the option to change to a different health plan. The customer is instructed to call the Communications Center or return the form to the Communications Center in Central Office by the end of the month to change to a different health plan. The customer does not need to do anything to remain with the same health plan. At the end of the month the health plans are notified of the upcoming enrollment changes.
The second month is the health plans’ transition month. This period allows health plans to arrange for the transition in case management and providers. The health plans must be allowed a minimum of one full calendar month to arrange for the transition in case management and providers so there is no interruption in the customer’s medical care and services.
AHCCCS accepts an annual enrollment change request through the last day of the transition month. However, the enrollment change will be delayed by one month to provide the required transition period.
After the annual enrollment period ends, the Communications Center refers all enrollment change requests received on or after the customer’s anniversary date to the ALTCS local office for resolution.
NOTE Customers that are enrolled in an EPD Health Plan plan need to have their enrollment aligned to their Dual Eligible Special Needs Plan (DSNP) with Medicare. When a customer wants to change their Health Plan that is aligned with their DSNP, they first need to change their DSNP with Medicare.
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Term |
Definition |
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Anniversary Month |
The month that coverage first goes into effect becomes its anniversary month each year. |
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Choice Month |
The first month of annual enrollment choice is the customer’s choice month. During this month the customer has the option to change to a different Health Plan. |
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Dual Eligible Special Needs Plan (DSNP) |
A type of Medicare Advantage (Part C) plan designed for persons who are eligible for both Medicare and Medicaid. |
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Transition Month |
The second month of annual enrollment choice is the Health Plans’ transition month. This period allows Health Plans to arrange for the transition in case management and providers. |
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Program |
Legal Authorities |
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ALTCS |
42 CFR 422.107 ARS 36-2933 AAC R9-28-413 |