June 12, 2020
SEP opportunity may be available to Medicare beneficiaries impacted by severe weather
CMS provides a special enrollment period (SEP) for individuals affected by severe weather who need to enroll in, disenroll from or switch Medicare health or prescription drug plans and have missed another enrollment period due to the severe weather. For those who qualify, the SEP begins on the first day of the incident period and runs for four full months from the beginning of the incident period.
Individuals impacted by Tropical Storm Cristobal in Louisiana are eligible for a SEP. It runs through October 31, 2020. Impacted parishes are shown below. Parishes in bold are those within Aetna’s MA/MAPD service area.
Acadia, Allen, Ascension, Assumption, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, Claiborne, Concordia, De Soto, East Baton Rouge, East Carroll, East Feliciana, Evangeline, Franklin, Grant, Iberia, Iberville, Jackson, Jefferson, Jefferson Davis, La Salle, Lafayette, Lafourche, Lincoln, Livingston, Madison, Morehouse, Natchitoches, Orleans, Ouachita, Plaquemines, Pointe Coupee, Rapides, Red River, Richland, Sabine, St. Bernard, St. Charles,
St. Helena, St. James, St. John the Baptist, St. Landry, St. Martin,
St. Mary, St. Tammany, Tangipahoa, Tensas, Terrebonne, Union, Vermilion, Vernon, Washington, Webster, West Baton Rouge, West Carroll, West Feliciana, Winn
Please note that affected parishes can change. For any updates to eligible parishes, please refer to https://www.fema.gov/disasters.
Who’s eligible for this SEP?
Individuals 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, and has designated affected parishes as being eligible to apply for individual or public level assistance;
- Had another valid election period at the time of incident period; and
- Did not make an election during that other valid election period.
In addition, the SEP is available to those individuals who don’t live in the affected areas but rely on help making health care decisions from friends or family members who live in the affected areas.
Guidance for Assisting Eligible Beneficiaries with this type of SEP
IMPORTANT: You cannot use this SEP opportunity to proactively market to beneficiaries. However, you can assist any clients who contact you about this SEP. Just ensure you follow the instructions below to avoid processing delays.
In the “Reasons for Special Enrollment Period Eligibility” section on the first page of the enrollment application, you’ll want to check the box for a weather-related SEP:
If you have any questions, please contact your local Aetna Medicare broker manager:
1 (800) 772-6881 x7731 | email@example.com