For Brokers: Enrollment and Eligibility

1. Know their plan choice
Know which plan the Medicare beneficiary has chosen and confirm their eligibility.


2. Confirm their primary care provider (PCP) information
All plans, except the SELECT (LPPO) and Flex (RPPO) plans, require that members have a primary care provider (PCP) who is in the Martin’s Point Generations Advantage network. The Generations Advantage provider network includes PCPs from Martin’s Point, InterMed, Dartmouth Hitchcock, MaineHealth, Northern Light, Maine General, Dartmouth-Hitchcock, Wentworth-Douglass, and more.

The Medicare beneficiary may choose their own PCP or a Generations Advantage representative will choose one for them. If the Medicare beneficiary chooses their own, you will need to enter the beneficiary’s in-network PCP’s name, address, and phone number on the enrollment form.

If they are enrolling in the SELECT (LPPO) or Flex (RPPO) plan, please enter their current health care provider’s name (not required to be in-network).


3. Have their Medicare card ready
You will need to enter their information from their red, white, and blue Medicare card on the enrollment form.

You are enrolling an eligible Medicare beneficiary in Generations Advantage, a Medicare Advantage plan. By clicking "ENROLL A MEMBER NOW" below, you acknowledge that you have reviewed the plan documents for the plan in which they are enrolling with the beneficiary. You also acknowledge you are completing the online enrollment on their behalf.

ENROLL A MEMBER NOW

Questions? 
Call your Broker Team: 1-877-789-6742

 

A Medicare beneficiary is eligible to enroll in Generations Advantage plans if they meet all of the following criteria:

• Are enrolled in Medicare Part A and Part B
• Reside in our service area, which includes Maine and New Hampshire
• Not currently diagnosed with end-stage renal disease (or receiving regular kidney dialysis)
• Enrolling during an eligible Medicare enrollment period

• If they’re turning 65: When a Medicare beneficiary first becomes eligible for Medicare, they can join during their 7-month initial enrollment period that begins 3 months before the month they turn 65, includes the month they turn 65, and ends 3 months after the month they turn 65
• If they’re already eligible for Medicare: Between October 15 and December 7, people who are eligible for Medicare can join, switch, or drop a Medicare Advantage plan. Their coverage will begin on January 1, as long as the plan gets their enrollment request by December 7
• If they get Medicare due to a disability: Medicare beneficiaries can join during the 7-month period that begins 3 months before their 25th month of disability and ends 3 months after their 25th month of disability

Between January 1 and March 31, if Medicare beneficiaries are enrolled in a Medicare Advantage plan, they can leave their plan and switch to another Medicare Advantage plan or Original Medicare. 

If they switch to Original Medicare during this period, they’ll have until March 31 to also join a Medicare Prescription Drug Plan (Part D) to add drug coverage. Their coverage will begin the first day of the month after the plan gets their enrollment request.

During this period, the Medicare beneficiary cannot:

• Switch from Original Medicare to a Medicare Advantage plan
• Switch from one Medicare Prescription Drug plan to another
• Join, switch, or drop a Medicare Medical Savings Account plan

In most cases, Medicare beneficiaries must stay enrolled for the calendar year starting the date their coverage begins.

However, in certain situations, they may be able to join, switch, or drop a Medicare Advantage plan during a Special Enrollment Period. Please have them contact their plan for additional information if they:

• Move out of their plan’s service area
• Have Medicaid
• Qualify for Extra Help
• Live in an institution like a nursing home