FEMA Announces Disaster Declarations SEP Enrollment Extensions
Great News. CMS granted a Special Enrollment Period (SEP) for beneficiaries impacted by FEMA Disaster Declarations. This SEP is for Medicare beneficiaries who could not submit a Medicare Advantage (MA/MAPD) or Prescription Drug (PDP) plan enrollment request due to the disaster. That includes both enrollment and disenrollment. Enrollments go into effect the first of the month after the plan receives the enrollment request.
Who Does This SEP Benefit?
This SEP applies to Medicare beneficiaries who reside in the following states/counties. Individuals are “affected” and eligible for the SEP if they:
- Reside, or resided, at the start of the incident period in an area FEMA declared an emergency or a major disaster, and has designated affected counties as being eligible to apply for individual or public level assistance
- Had another valid election period at the time of the incident period
- Did not make an election during that other valid election period
- Also, the SEP is available to individuals who do not live in the affected areas but rely on making healthcare decisions from friends or family members who live in the affected areas.
When Is It Available?
The SEP is available from the start of the incident period and for four full calendar months after the start of the incident period. Eligible beneficiaries have one opportunity to make that missed election as a result of this SEP. The enrollment period can be specific to that beneficiary (i.e., loss of Special Needs Plan or moving out of the area.) Beneficiaries are not expected to prove that they live in an affected area, but if they have a driver’s license or utility bill, they should provide it. Agents must fully verify as best as they can before accepting the application. If there are questions about eligibility, CMS will make the determination. Beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, 7 days a week if they have questions about eligibility for this SEP. TTY users should call 1-877-486-2048.
Agents
We hope this information on FEMA Announces Disaster Declarations SEP is helpful to you.
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