CMS has established a special enrollment opportunity for individuals affected by a weather-related emergency or major disaster who need to enroll in, disenroll from or switch Medicare health or prescription drug plans and missed other enrollment periods. This opportunity will be available in areas for which the Federal Emergency Management Agency (FEMA) has declared an emergency or a major disaster. It is available as of the start of the incident period and runs for 4 full calendar months. Enrollments are effective the first of the month after the plan receives your enrollment request. To see a list of the most recent declared disasters visit fema.gov/disasters
Medicare rules in a disaster or emergency area
According to Medicare.gov, the rules for getting care may change for a short time in areas where one of these has happened:
- The President has declared it an emergency or disaster. Visit the Federal Emergency Management Agency (FEMA), or call 1-800-621-FEMA to see if your area is affected.
- A governor has declared it an emergency or disaster. Visit your state government’s official website to find out if your area is affected.
- The Secretary of the Department of Health and Human Services (HHS) has declared a public health emergency. Visit the HHS Public Health Emergency website. Or call 1-800-MEDICARE to find out if your area is affected.
Who qualifies for this 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 the Federal Emergency Management Agency (FEMA) 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 another special opportunity).
- 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.
Escalated FEMA State of Emergency (SOE)
- Florida
- Counties: Osceola & Seminole
- SEP is valid 08/28/2019 – 12/28/2019
- South Carolina
- Counties: Chester, Greenville, Lancaster, Spartanburg, Union, York
- SEP is valid 08/31/2019 – 12/31/2019
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- Counties: Alexander, Cabarrus, Catawba, Cleveland, Davidson, Davie, Forsyth, Guilford, Iredell, Lincoln, Polk, Rowan, Stokes, Union, Yadkin
- SEP is valid 08/31/2019 – 12/31/2019
- Texas
- Counties: Chambers, Harris, Jefferson, Liberty, Montgomery, Orange, San Jancinto
- SEP is valid 09/19/2019 – 01/19/2020
The following are the most recent declared disasters found on www.fema.gov/disasters
- Florida Hurricane Dorian (DR-4468)
- Disaster declared October 21, 2019
- Counties: Brevard, Duval, Flagler, Indian River, Martin, Nassau, Osceola, Palm Beach, Putnam, Seminole, St. Johns, St. Lucie
- Extended SEP December 20, 2019
- Hawaii Kahana Ridge Fire (FM-5294)
- Disaster declared October 22, 2019
- County: Maui
- Extended SEP December 21, 2019
- California Kincade Fire (FM-5295)
- Disaster declared October 24, 2019
- County: Sonoma
- Extended SEP December 23, 2019
- California Tick Fire (FM-5296)
- Disaster declared October 24, 2019
- County: Los Angeles
- Extended SEP to December 23, 2019
- California Getty Fire (FM-5297)
- Disaster declared October 28, 2019
- County: Los Angeles
- Extended SEP to December 27, 2019
- California Hill Fire (FM-5299) and (FM-5300)
- Disaster declared October 30, 2019
- County: Riverside
- Extended SEP to December 29, 2019
- California 46 Fire (FM-5301)
- Disaster declared October 31, 2019
- Counties: San Bernardino
- Extended SEP to December 30, 2019
- California Maria Fire (FM-5302)
- Disaster declared November 1, 2019
- Counties: Ventura
- Extended SEP to December 31, 2019
- South Dakota Severe Storms, Tornadoes, And Flooding (DR-4469)
- Disaster declared November 18, 2019
- Counties: Brookings, Charles Mix, Davison, Flandreau Indian Reservation, Hanson, Hutchinson, Lake, Lincoln, McCook, Minnehaha, Moody, Yankton, Yankton Indian Reservation
- Extended SEP to January 17, 2020
- Oklahoma Gauge Fire (FM-5305)
- Disaster declared November 26, 2019
- Counties: Ellis
- Extended SEP to January 25, 2020
- Oklahoma Highway 50 Fire (FM-5304)
- Disaster declared November 26, 2019
- Counties: Woodward
- Extended SEP to January 25, 2020
- California Cave Fire (FM-5303)
- Disaster declared November 26, 2019
- Counties: Santa Barbara
- Extended SEP to January 25, 2020
- Tennessee Severe Storm And Straight-line Winds (DR-4471)
- Disaster declared December 06, 2019
- Counties: Benton, Decatur, Hardin, Henderson, Houston, Humphreys, McNairy, Montgomery, Perry, Wayne
- Extended SEP to February 4, 2020
- Mississippi Severe Storm, Straight-line Winds, And Flooding (DR-4470)
- Disaster declared December 06, 2019
- Counties: Alcorn, Covington, Itawamba, Jasper, Jefferson Davis, Leake, Lee, Marion, Neshoba, Newton, Pontotoc, Prentiss, Scott, Simpson, Smith, Tippah
- Extended SEP to February 4, 2020
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