Generally, a Managed Care Organization (MCO) must accept enrollments during certain designated enrollment periods, e.g., the Annual Coordinated Enrollment Period, Initial Coverage Election Period, Special Election Periods, etc.  When an MCO has an approved capacity limit, it may, during such periods that it would otherwise be required to accept enrollments:  1) stop enrolling beneficiaries once the enrollment capacity limit number is reached, but, if needed, 2) set aside a specified number of enrollment vacancies in order to enroll members who "age-in" from the MCO's commercial product into its Medicare product.  Capacity limits may be based on several different reasons and the limit may apply to plan benefit packages or counties in different configurations, e.g., by plan, by county.  In some cases, the reason for the request and the period in which the capacity limit is in effect, for example, either a full or partial year, dictates how the MCO's capacity limit may be applied to the service area or plan benefit packages.

Downloads
Medicare Advantage Capacity Limits Approved/Lifted for 2006 (PDF, 13KB) Medicare Advantage Capacity Limit Information for 2005 (PDF, 16KB) - Updated 12/12/05 Medicare Advantage Capacity Limit Information for 2005 (ZIP, 6KB) - Updated 12/12/05 Medicare Advantage Capacity Limit Information for 2004 (PDF, 19KB) Medicare Advantage Capacity Limit Information for 2004 (ZIP, 6KB) Medicare Advantage Capacity Limit Information for 2003 (pdf, 55KB) Medicare Advantage Capacity Limit Information for 2003 (xls, 7KB) Medicare Advantage Capacity Limit Information for 2002 (pdf, 40KB) Medicare Advantage Capacity Limit Information for 2002 (xls, 8KB)
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Page Last Modified: 09/03/2008 9:46:39 AM
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