Yes. If you live in an area where a federal, state, or local government entity (such as the Federal Emergency Management Agency (FEMA)) declared an emergency or major disaster, and you were not able to take advantage of an enrollment period - such as your Initial Enrollment Period (
IEP) or the annual Open Enrollment Period (
AEP) or a Special Enrollment Period (
SEP) - you will be granted a Special Enrollment Period from "the date the declaration is made, the incident start date or, if different, the start date identified in the declaration, whichever is earlier. "
The Special Enrollment Period "ends 2 full calendar months following the end date identified in the declaration or, if different, the date the end of the incident is announced, whichever is later."
During the "Government Entity-Declared Disaster or Other Emergency" SEP (previously known as the "FEMA-Declared Weather Related Emergency or Major Disaster"
SEP), Medicare beneficiaries will have the opportunity to enroll in,
disenroll from, or change their Medicare Part D or Medicare Advantage
plan coverage.
Any enrollment decisions will become effective the first day of the
month after the Medicare plan receives the enrollment decision.
Please refer to your local or state government website regarding declared disasters or you can refer to the:
- Centers for Medicare and Medicaid Services (CMS) "Current
non-Covid emergencies"
(https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/current-non-covid-emergencies)
or
- CMS "Current emergencies"
(https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page)
or
- CMS "Ongoing emergencies & disasters"
(https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Ongoing-emergencies)
or
- FEMA website to see the date of when a specific disaster was declared: www.fema.gov/disasters.
To learn more about using this Special Enrollment Period, please call a
Medicare representative at: 1-800-633-4227 (TTY 1-877-486-2048).
The Major Disaster SEP and the coronavirus / COVID-19 Pandemic
In 2020, the Centers for Medicare and Medicaid Services (CMS)
announced
that people who were unable to change their Medicare Part D drug plan
or Medicare Advantage plan enrollment due to the COVID-19 pandemic, can
use the Major Disaster Special Enrollment Period (SEP) to join or change
a 2020 Medicare plan. The SEP began in
March 2020 and continued only through June 30, 2020. However, with the
January 1, 2021 changes to the Medicare enrollment guidance, this COVID-19 SEP may extend longer.
As noted by CMS:
"As the Centers for Medicare & Medicaid Services (CMS) is
working to identify policies and procedures we can put in place to help
partners who are responding to the COVID-19 pandemic, we would like to
clarify for Medicare Advantage (MA) and Part D plan sponsors that the
exceptional conditions Special Enrollment Period (SEP) adopted under 42
CFR 422.62(b)(4) and 423.38(c)(8)(ii) for Individuals Affected by a
FEMA-Declared Weather Related Emergency or Major Disaster is applicable
and is available for beneficiaries who were eligible for -- but unable
to make -- an election because they were affected by the COVID-19
pandemic and meet the terms of the SEP . . . ."
You can click here to read more about the COVID-19 SEP:
Q1News.com/821.
Question: How does a person qualify for the Natural Disaster Special Enrollment Period?
"The special opportunity to enroll in,
disenroll from or switch Medicare health or prescription drug plans
applies to all individuals who:
- Reside, or resided at the
start of the incident period, in an area for which a government entity has declared an emergency or a major disaster;
- Had
another enrollment period at the time of the incident period (such as
the Fall Open Enrollment Period or other special opportunity); and
- Did
not enroll or make a change during that other enrollment period.
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. The SEP starts
as of the date the declaration is made, the incident start date or, if
different, the start date identified in the declaration, whichever is
earlier. The SEP ends 2 full calendar months following the end date
identified in the declaration or, if different, the date the end of the
incident is announced, whichever is later."
Question: I lost most of my personal possessions during the disaster, how do I prove that I am eligible for this SEP?
If you do not have any formal identification (such as a driver's
license, passport, utility bill), you can attest that you were living in
the impacted area during the natural disaster.
As noted by Medicare:
"If the plan asks you for proof that you reside in an affected area
(e.g., driver’s license, utility bills, etc.) and you have it, you
should provide it to the plan. However, if your documents were destroyed
or you don’t have access to them, you can attest to residing in one of
the affected areas, as defined by the Federal Emergency Management
Agency (FEMA)."
Question: How can I use this Special Enrollment Period to change Medicare plans?
You
can join a Medicare plan using the Disaster SEP by calling a
Medicare representative at 1-800-Medicare (1-800-633-4227) or by working
with a local insurance agent or by calling the Medicare plan's enrollment number
directly.
If you cannot find the plan's telephone number, we have Member
Service telephone numbers for most Medicare Part D plans in our Medicare
Part D plan finder -
PDP-Finder.com
– just choose your state and click on the plan name. We have the same
Member Services contact information on our Medicare Advantage plan coverage
pages (start with
MA-Finder.com and
enter your ZIP code and then click on the plan name you wish to reach) – the Member
Service’s telephone number is listed at the top of the plan detail page.
If you are enrolling into a Medicare plan by submitting a printed or
paper application form, you may see an Enrollment Period option on the
Medicare
plan enrollment application that may read something like this:
"I was affected by an emergency or major disaster (as declared by the
Federal Emergency Management Agency (FEMA)) or by a Federal, state or
local government entity. One of the other statements here applied to me,
but I was unable to make my enrollment request because of the
disaster."
If this statement is
not available on your application, you may wish to telephone the
Medicare plan and ask a plan representative to help you complete the
application
.
Sources include:
Medicare Managed Care Manual, Chapter 2 - Medicare Advantage Enrollment
and Disenrollment, Updated: August 19, 2011 (Revised: November 16, 2011,
August 7, 2012, August 30, 2013, August 14, 2014, July 6, 2015,
September 1, 2015, September 14, 2015, December 30, 2015, May 27, 2016,
August 25, 2016, June 15, 2017, July 31, 2018 & August 12, 2020),
Section 30.4.4 (p.46)
Medicare Prescription Drug Benefit Manual Chapter 3 - Eligibility,
Enrollment and Disenrollment, Updated: August 19, 2011 (Revised:
November 16, 2011, August 7, 2012, August 30, 2013, August 30, 2014,
July 6, 2015, September 1, 2015, September 14, 2015, December 30, 2015,
May 27, 2016, August 25, 2016, June 15, 2017, July 31, 2018, August 12,
2020), Section 30.3.8 (p.40)
https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/8-9-natural-disaster-SEP.pdf
https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/Downloads/Disaster_SEP_QAs_for_Beneficiaries.pdf
For additional information, please see: "Medicare rules in a disaster or emergency area"
https://www.medicare.gov/what-medicare-covers/medicare-rules-in-a-disaster-or-emergency-area
https://www.cms.gov/files/document/special-enrollment-period-sep-individuals-affected-fema-declared-weather-related-or-other-major.pdf