When Can Someone Join Or Leave an MSA?

The answer depends on whether it’s an individual MSA plan or a Fenyx Health Group MSA plan.

Joining an MSA

Medicare considers MSA enrollment on a full calendar year basis. So, there are different enrollment (joining) periods for MSAs versus other plans.

Enrollment in the Fenyx Health Group MSA is more flexible than an individual MSA:

  • Eligible beneficiaries can join the Fenyx Health Group MSA at any time of the year.

  • The benefit period end will always be 12/31 of the current year, even for partial-year enrollments.

Coverage starting anytime after 1/1 of the current year is considered a “partial-year enrollment.”

  • During the Annual Enrollment Period (AEP) each October 15 – December 7.

  • During an Initial Coverage Election Period (ICEP), when a person first becomes eligible for Medicare.

  • Individual MSAs cannot be joined during Open Enrollment Period (OEP) each January 1 – March 31.

  • Individual MSAs cannot be joined during Special Election Periods (SEP) such as moving into the MSA availability area, etc.

Leaving an MSA

There are also different disenrollment (leaving) periods for MSAs versus other plans.

Enrollment in the Fenyx Health Group MSA is through December 31 of each year and is “evergreen.” This means members will continue to be enrolled until the end of the benefit period (12/31) for the current year and for successive January 1 – December 31 benefit periods/year until one of the following happens:

  • The group no longer offers the plan.

  • The member notifies us before December 1 of their intention to not continue enrollment for the next year (they must remain in the plan until 12/31 of the current year).

  • Permanently moving out of the MSA’s availability area (i.e., outside of the 50 states or Washington, D.C.)

  • Gaining Medicaid eligibility.

  • Gaining other coverage that duplicates what the MSA deductible covers.

  • The member passes away.

If the member leaves the plan, for any reason, before the end of the current benefit period (12/31 of the current year), it is considered a “partial-year enrollment.”

Disenrollments become effective at the end of the month in which they occur. For example, if a member moves out of the service area on August 9, their coverage remains in effect until August 31.

The exception to this is when a member notifies us of their intention to not renew for the upcoming year; they will remain enrolled in the plan through December 31. In other words, a member declining to renew for the upcoming year cannot leave the plan before December 31 of the current year unless they meet one of the other early disenrollment criteria.

  • During the Annual Enrollment Period (AEP) each October 15 – December 7.

  • Permanently moving out of the MSA’s availability area.

  • Gaining Medicaid eligibility.

  • Gaining other coverage that duplicates what the MSA deductible covers.

  • Enrolling in a 5-star plan.

  • The member passes away.

  • Individual MSAs cannot be left during Open Enrollment Period (OEP) each January 1 – March 31.

  • Individual MSAs cannot be left during the three months after first becoming eligible for Medicare (ICEP).

Partial-year Enrollments

When Fenyx Health Group MSA coverage begins after January 1 and/or ends before December 31 of a particular year, it is considered a “partial-year enrollment.”

As the MSA is designed to operate on a full calendar year basis, partial-year enrollments are subject to prorated deposit and deductible amounts.

See the next lesson for detailed information about prorated deposits and deductibles.

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