The Centers for Medicare and Medicaid Services (CMS) announced that Medicare providers affected by the pandemic will be eligible for a Special Enrollment Period (SEP) to switch, disenroll from, enroll in a Medicare Advantage plan or Medicare Prescription Drug plan. This SEP will run through July 1st, 2020.
Those affected by COVID-19 are:
- Recipients that have been diagnosed with COVID-19 or are experiencing symptoms of COVID-19 and are seeking a medical diagnosis
- A member of reciepient’s household has been diagnosed with COVID-19
- Recipient is providing care for a family member or a member of their household who has been diagnosed with COVID-19
Who is eligible?
Any recipient who resides in, or resided in, the 50 United States or the District of Columbia, where the Federal Emergency Management Agency (FEMA) has declared an emergency or major disaster is eligible for the SEP.
Recipients who were unable to enroll in or dis-enroll from a plan during another qualifying election period OR recipients who receive judgement assistance from someone affected by COVID-19, also qualify for this SEP.
More specifically, recipients who are eligible:
- Were unable to take advantage of the final month of OEP
- Aged in and missed their enrollment window
- Moved from one county or state to another location
- Had a change in their Medi-Cal or LIS status
- Lost their employee group coverage
- Were prevented from enrollments during any other qualifying SEP opportunity
- Additional scenarios for eligibility could apply
Agent action:
If a recipient contacts you as a result of this SEP, you may help them enroll in one of our plans and earn a commission. You must:
- Once you verify eligibility, you can proceed with the application
- No burden of proof will be placed upon the recipient during this SEP
- Use the SEP election box on the application that includes: “I was affected by a Weather Related Emergency or Major Disaster.”
Reminder:
This SEP is only available to beneficiaries and their decision makers who were affected during the incident period and should not be used as a tool to generate new enrollments.
