Individuals affected by the hurricanes in Texas, Louisiana, Florida, Georgia, South Carolina, Alabama, Mississippi, Puerto Rico, and the U.S. Virgin Islands will be eligible to switch, enroll and disenroll in MAPD and PDP plans until December 31st.
Individuals affected by Hurricanes Harvey, Irma, and Maria, and Tropical Storm Nate have an extended amount of time to enroll in healthcare this year. CMS is allowing a Special Enrollment Period (SEP) that gives them the chance to change their MAPD or PDP plan. Why? Many Americans were unable to speak with an agent and shop for healthcare plans during the qualifying election period due to the storms. AEP runs between October 15th and December 7th. However, individuals that qualify for the hurricane special enrollment period will be able to enroll in MAPD or PDP plans up until December 31st.
Are You Eligible for This Hurricane Special Enrollment Period?
The states included are Texas, Florida, Georgia, South Carolina, Alabama, Mississippi, Puerto Rico, and the U.S. Virgin Islands. FEMA has recently added Alabama and Mississippi to the list. Individuals will be considered “affected” and eligible for the hurricane special enrollment period if they reside, or resided at the start of the incident period, in an affected area. The Federal Emergency Management Agency (FEMA) has declared areas of emergency or a major disaster. Also, the SEP is available to individuals who don’t live in the affected areas, but rely on others in those areas to help with making healthcare decisions. For example, a senior, who relies on her daughter Susan to help her understand and choose her Medicare Advantage plan every year, will be eligible for the SEP if Susan was affected by Harvey and could not help her mother during AEP.
Eligibility determination varies from carrier to carrier. Agents may ask you to show a driver’s license or utility bill. This will count as proof that you lived in an affected county at the time of the event. Some carriers will have you attest to your eligibility in writing, while others will accept a verbal attestation.
Details About the SEP
The effective date for the new plan coverage will be the first day of the month after the month CMS receives the enrollment request. The effective date of the disenrollment will be the last day of the month if the SEP is being used to disenroll from an existing plan. If the individual is changing plans, the plan change will disenroll the individual from their current plan; a separate disenrollment transaction is not required. This is a one-time SEP. You cannot sign up for more than one MAPD using the SEP. Furthermore, you cannot use this SEP if you enrolled in a plan during regular AEP. This SEP is in addition to AEP and other enrollment periods for which you may be eligible.