Questions billers ask › Can a SNF resident switch I-SNP plans mid-year?

Can a SNF resident switch I-SNP plans mid-year?

Answered from the public Medicare sources on 2026-10-01. The quoted text is the source; the note beneath it is what our AI found. You decide what applies to your claim.

The rule, word for word

“An open enrollment period for institutionalized individuals (OEPI) is available for individuals who meet the definition of an “institutionalized individual” to enroll in or disenroll from an I-SNP. Refer to the Medicare Advantage Enrollment and Disenrollment Guidance for further information about the OEPI.”

Pub 100-16 Ch 16b § 40.6, 40.6 - Open Enrollment Period for Institutionalized Individuals
Captured2026-05-26
sha256:53bb7336…df3f2600 · Source

What our AI found in the sources

Yes. A long-term care facility resident who meets the "institutionalized individual" definition has an ongoing Open Enrollment Period for Institutionalized Individuals (OEPI), which lets them enroll in or disenroll from an Institutional SNP (I-SNP) at any time -- not just during the standard annual enrollment window. That OEPI continues until the second month after the individual actually leaves the long-term care facility setting.

Also cited

42 CFR § 422.62, Subpart B -- Eligibility, Election, and Enrollment -- § 422.62 Election of coverage under an MA plan.
Published2026-04-06 Captured2026-04-06
sha256:eeb64885…f184d3b3 · Source

If this comes up on one of your claims

The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.

Ask it your own question and get the same thing back: the governing rule, quoted, with a citation that still verifies later.

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