If you are a Medicare beneficiary affected by
Hurricane Harvey,
Irma,
Maria,
or
Nate you are entitled to a "
weather related emergency or major disaster" Special Enrollment Period (
SEP) extending the 2018 annual Open Enrollment Period through
December 31, 2017 - allowing you more time to choose or drop a 2018 Medicare Part D or Medicare Advantage plan.
In addition, residents of Puerto Rico and the U.S. Virgin Islands affected by the hurricanes - and California residents affected by the wildfires will have this "disaster" SEP extended to
March 31, 2018.
As a reminder, the 2018 annual Medicare Open Enrollment Period (or
Annual Election Period – AEP) began on October 15th and continued through December 7th. During the annual Open Enrollment Period, you had the opportunity to join, change, or drop your Medicare Part D or Medicare Advantage plan coverage. After December 7th, most people only have a limited opportunity to change their 2018 Medicare plan coverage and are “locked in” to their plan for the remainder of the year - unless they have the opportunity to use an
SEP.
As noted in the September 28, 2017 press release issued by the Centers for Medicare and Medicaid Services (CMS):
"As a result of Hurricanes Harvey, Irma, and Maria,
the Centers for Medicare & Medicaid Services (CMS) will make
available special enrollment periods for all Medicare beneficiaries and
certain individuals seeking health plans offered through the Federal
Health Insurance Exchange. This important step gives these individuals
and families who have been impacted by the hurricanes the opportunity to
change their Medicare health and prescription drug plans and gain
access to health coverage on the Exchange immediately if eligible for a
special enrollment period.
. . .
Medicare special enrollment period: This special enrollment period will allow individuals affected by these hurricanes to enroll, dis-enroll or switch
Medicare health or prescription drug plans. It is available at the
start of the incident period and runs through the end of the calendar
year."
If you are a Medicare beneficiary who was affected by
Hurricane Harvey, Irma, or Maria and you need more time to complete your
2018 Medicare plan enrollment, please telephone Medicare at
1-800-633-4227 and speak with a Medicare representative for more
information.
Update: Who is covered by this SEP?
This "natural disaster" SEP is being offered until 12/31/2017 (unless noted below) to residents of the following states and territories affected by the disasters. Please note that
this SEP is available only in areas where the Federal Emergency Management Agency (FEMA) has declared an emergency or a major disaster - and this may mean that only residents of selected counties within a state can use this SEP).
- Alabama,
- California (due to wildfires - SEP until 3/31/2018 - see below),
- Florida,
- Georgia,
- Louisiana,
- Mississippi,
- Puerto Rico (SEP until 3/31/2018 - see below)
- South Carolina,
- Texas, and
- U.S. Virgin Island (SEP until 3/31/2018 - see below).
As noted above, the Centers for Medicare and Medicaid Services (CMS) has stated that "[i]ndividuals will be considered 'affected' and
eligible for this SEP if they reside, or resided at the start of the
incident period,
in an area
for which the Federal Emergency Management Agency (FEMA) has declared
an emergency or a major disaster. In addition, the SEP is available to
those individuals who don’t live in the affected areas but rely on help
making healthcare decisions from friends or family members who live in
the affected areas."
Important: People with End-Stage Renal Disease (ESRD or Kidney Failure)
If you suffer from ESRD, this SEP will
not allow you to join another Medicare Advantage plan. The Centers for Medicare and Medicaid Services specifically added this caution:
"We note that individuals with End-Stage Renal Disease (ESRD) have additional limitations that
do not permit enrollment in another Medicare Advantage organization,
even if they are eligible for a SEP. Such individuals should consider their options carefully before using this SEP to leave their current Medicare Advantage plan, as Medicare Fee-for-Service may be their only option. Should a displaced individual with ESRD leave their current plan then return to Puerto Rico or the U.S. Virgin Islands, he or she
would not be eligible to join their prior or another Medicare Advantage plan." [emphasis added]
Update: Puerto Rico and U.S. Virgin Islands SEP extended to March 31, 2018.
On December 14, 2017, the Centers for Medicare and Medicaid Services
(CMS) extended the Special Enrollment Period to residents of Puerto Rico and the U.S. Virgin Islands until 03/31/18. CMS noted that, "[t]his SEP provides affected individuals with an
additional one-time opportunity to add, drop or change their Medicare health and prescription drug plans. Individuals will be considered “affected” and eligible for this SEP if they reside, or resided at the start of the incident period, in Puerto Rico or the U.S. Virgin Islands. This SEP can be used,
even if the person made a choice during Medicare’s fall open enrollment period, and it helps those who left Puerto Rico and feel that a local Medicare Advantage or Medicare prescription drug plan would better meet their healthcare needs." [emphasis added]
Update: California Wildfire SEP extended to March 31, 2018.
CMS also extended the "disaster" Special Enrollment Period until 03/31/18 for people in California affected by the wildfires, allowing people the opportunity to "add, drop or change their Medicare health and prescription drug plan in the event they were unable to make an election during the fall open enrollment period [
AEP] or another election period [such as an Initial Enrollment Period] for which they were eligible." However, this SEP
is not available to people who already chose another Medicare plan during the AEP. CMS added clarification that, "... an individual can use this SEP once for each election period they missed. Thus, individuals who made an election during the annual election period (AEP)
cannot use this SEP to make a second AEP election." [emphasis added]
(
Sources: CMS Press Release -- https://www.cms.gov/ Newsroom/ MediaReleaseDatabase/ Press-releases/ 2017-Press-releases-items/ 2017-09-28.html, -- https://www.cms.gov/ About-CMS/ Agency-Information/ Emergency/ Downloads/ Disaster-Memo-Medicare-SEP.pdf. -- https://www.cms.gov/ About-CMS/ Agency-Information/ Emergency/ Downloads/ Extension-SE-Period- PR-VI-CA-Wildfire.pdf) [emphasis added]