Yes. If you are enrolled in a Medicare Part D or Medicare Advantage plan that was sanctioned by the Centers for Medicare and Medicaid Services (CMS or Medicare), then you may be granted a Special Enrollment Period (or SEP) that would allow you to change your Medicare Advantage Plan or Medicare Part D prescription drug plan to another Medicare plan that is available in your area.
As noted in the Medicare Manual:
"On a case-by-case basis, CMS will establish an SEP if CMS sanctions a PDP sponsor, and an enrollee disenrolls in connection with the matter that gave rise to that sanction. The start/length of the SEP, as well as the effective date, is dependent upon the situation."
Please note that, unlike other SEPs, this Special Enrollment Period is determined "by Medicare on a case-by-case basis" and the SEP must be based on Medicare plan behavior that gave rise to the sanctions. To learn more, please speak with a Medicare representative (1-800-633-4227).
You can click on the following link for some past examples of Medicare plans that were sanctioned by CMS
on this site medicare-plan-providers/15/
You can click on the following link to see other examples of Special Enrollment Periods (SEPs)
on this site
Question: Can I see coverage information for sanctioned Medicare plans?
Yes. We show “sanctioned” Medicare plans within the this site® Medicare Part D Plan Finder (PDP-Finder.com) and Medicare Advantage Plan Finder (MA-Finder.com) so current plan Members can still find plan coverage information.
As an example, in September 2020, CMS sanctioned the Idaho Medicare Advantage plan “Secure Blue no Rx (PPO) - H1302-004-0 and prohibited the Medicare Advantage plan from accepting plan enrollments "beginning January 1, 2021, through December 1, 2021". However, current plan members were not affected by the CMS sanctions and were allowed to remain with the Medicare plan into 2021 - and still would need information about their 2021 Medicare plan coverage.
To provide information about this 2021 Medicare plan, we displayed the “Secure Blue no Rx (PPO) - H1302-004-0” within our Medicare Advantage Plan Finder marked with a dark red rectangle and the text “Sanctioned Plan” (see: MA-Finder.com/2021/83713).
If a person wishes to see more coverage information, they can click on the Medicare Advantage plan's name or the “Sanctioned Plan” button and they will be shown the plan benefit details along with another large dark red box with the message: "This Plan is currently sanctioned and is not accepting enrollments".
The Medicare.gov Plan Finder does show sanctioned Medicare plans after you click on the "View sanctioned plans" link found at the bottom of the plan summary page. However, Medicare only shows basic plan contact information and a link to the sanctions letter from CMS. Plan coverage information for current members of the sanctioned Medicare plan is not provided (as of April 29, 2021).
As noted in the Medicare Manual:
"On a case-by-case basis, CMS will establish an SEP if CMS sanctions a PDP sponsor, and an enrollee disenrolls in connection with the matter that gave rise to that sanction. The start/length of the SEP, as well as the effective date, is dependent upon the situation."
Please note that, unlike other SEPs, this Special Enrollment Period is determined "by Medicare on a case-by-case basis" and the SEP must be based on Medicare plan behavior that gave rise to the sanctions. To learn more, please speak with a Medicare representative (1-800-633-4227).
You can click on the following link for some past examples of Medicare plans that were sanctioned by CMS
on this site medicare-plan-providers/15/
You can click on the following link to see other examples of Special Enrollment Periods (SEPs)
on this site
Question: Can I see coverage information for sanctioned Medicare plans?
Yes. We show “sanctioned” Medicare plans within the this site® Medicare Part D Plan Finder (PDP-Finder.com) and Medicare Advantage Plan Finder (MA-Finder.com) so current plan Members can still find plan coverage information.
As an example, in September 2020, CMS sanctioned the Idaho Medicare Advantage plan “Secure Blue no Rx (PPO) - H1302-004-0 and prohibited the Medicare Advantage plan from accepting plan enrollments "beginning January 1, 2021, through December 1, 2021". However, current plan members were not affected by the CMS sanctions and were allowed to remain with the Medicare plan into 2021 - and still would need information about their 2021 Medicare plan coverage.
To provide information about this 2021 Medicare plan, we displayed the “Secure Blue no Rx (PPO) - H1302-004-0” within our Medicare Advantage Plan Finder marked with a dark red rectangle and the text “Sanctioned Plan” (see: MA-Finder.com/2021/83713).
If a person wishes to see more coverage information, they can click on the Medicare Advantage plan's name or the “Sanctioned Plan” button and they will be shown the plan benefit details along with another large dark red box with the message: "This Plan is currently sanctioned and is not accepting enrollments".
The Medicare.gov Plan Finder does show sanctioned Medicare plans after you click on the "View sanctioned plans" link found at the bottom of the plan summary page. However, Medicare only shows basic plan contact information and a link to the sanctions letter from CMS. Plan coverage information for current members of the sanctioned Medicare plan is not provided (as of April 29, 2021).
- Browse Medicare Part D prescription drug plans
- Browse Medicare Advantage plans (MAPD)
- Sign-up for our Medicare Part D Newsletter.
- Still have a question? Click here to let us know.