Attention: Agents

SEP Notice for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster

CMS provides a Special Enrollment Period (SEP) for individuals who need to enroll in, disenroll from or switch Medicare health or prescription drug plans and have missed another enrollment period (i.e., either aging in or a SEP) due to a weather event or other disaster.  Although President Trump issued a federal emergency declaration due to COVID on March 13, 2020, CMS has clarified its position in preliminary guidance advising that the SEP should not be used for individuals impacted by COVID.

Effective today, 12/22, agents should discontinue use of this SEP for COVID related enrollments.  However, because these individuals may be eligible to use the exceptional circumstances SEP, agents are encouraged to refer beneficiaries to 1-800-Medicare for enrollment assistance from CMS.

As a reminder, the SEP-DST may still be used for individuals who meet the following requirements, as they relate to weather related disasters.

  • Reside, or resided at the start of the incident period, in an area for which FEMA has declared an Emergency or Major Disaster as has designated affected counties as eligible to apply for individual or public level assistance;
  • Had another valid election period at any time during the incident period; and
  • Did not make an election during that other valid election period.

For additional details, please refer to the SEP Disaster Notice article sent out in the December 17th Newsletter.