If a natural disaster interfered with your ability to sign up for Medicare, there's a Special Election Period for that.
The Medicare program recognizes that beneficiaries may experience special circumstances that hinder their ability to sign up for Medicare or make changes during enrollment periods. To account for this, Medicare created Special Election Periods (SEPs), also known as Special Enrollment Periods.
There are myriad ways to qualify for an SEP. Losing your current coverage, moving, and qualifying for Medicaid are some of the more common special circumstances. But the Centers for Medicare & Medicaid Services (CMS) also provides one for Medicare beneficiaries who live in areas where the Federal Emergency Management Agency (FEMA) has declared a disaster or emergency. CMS calls this a "Special Enrollment Period for Individuals Affected by a FEMA-Declared Weather-Related Emergency or Other Major Disaster."
How Does the Disaster-Related Special Enrollment Period Work?
If you live in an area that was impacted by a natural disaster or emergency and this prevented you from taking action during a Medicare enrollment period, you qualify for this Special Election Period. The SEP also applies to Medicare beneficiaries who do not live in an affected area but who rely on the assistance of someone who does.
The Special Election Period for disaster declarations begins with the disaster or emergency and lasts for four calendar months. Any enrollments made during the SEP take effect on the first of the month following the plan's receipt of your request. So, if the plan receives your enrollment request in November, your coverage effective date is December 1.
Please note that you are only eligible for the disaster SEP if you did not make elections during the Medicare enrollment period that occurred during the disaster or emergency. For example, if you already made changes to your Medicare coverage during the Annual Enrollment Period (AEP), you may not use the disaster SEP to make more changes once AEP ends.
You may only make Medicare coverage changes once during the Special Election Period for disaster declarations.
Current Disaster-Related SEPs
These are the disaster-related SEPs as of October 18, 2021:
- Florida Tropical Storm Nicole: Incident period began on November 7, 2022; FEMA declaration November 9, 2022
- Washington Nakia Creek Fire: Incident period began on October 9, 2022; Fire Management Assistance declaration October 17, 2022
- New York Lake Effect Western NY: Incident period began on November 18, 2022; FEMA declaration November 20, 2022
- Oregon Milo Mciver Fire: Incident period began on September 10, 2022; Fire Management Assistance declaration September 10, 2022
- Idaho Ross Fork Fire: Incident period began on September 5, 2022; Fire Management Assistance delcaration September 5, 2022
This is only a partial list of disaster declarations. Find the complete list at FEMA.gov here.
What Are Valid Election Periods?
For the FEMA SEP to apply, it must interfere with a valid election period. There are multiple Medicare enrollment periods every year.
- Initial Enrollment Period (IEP): Your IEP lasts a full 7 months, beginning 3 months before you become eligible for Medicare (your 65th birthday or 25th month of collecting either Railroad Retirement Board (RRB) or Social Security disability benefits).
- Medicare Advantage Open Enrollment Period (OEP): Current Medicare Advantage enrollees may either change to a different Advantage plan or return to Original Medicare during OEP, which lasts from January 1 through March 31.
- General Enrollment Period (GEP): If you did not enroll in Medicare Part A and/or Medicare Part B during your IEP AND you do not qualify for an SEP, you can sign up during General Enrollment from January 1 through March 31.
Eligibility Requirements for the Natural Disaster Special Enrollment Period
To take advantage of the FEMA Special Enrollment Period, all of the following must apply:
- At the start of the incident period, you resided in the area where FEMA declared an emergency or disaster
- There was another enrollment period, such as AEP or another SEP, that occurred during the incident period
- You did not enroll in Medicare or a Medicare plan or make any changes to your current coverage during the other enrollment period
Again, if you rely on someone to assist you with healthcare decisions and that person is the one who lives in a disaster area, you also qualify for this SEP.
How Do You Take Advantage of the Disaster SEP?
You have a number of options to use the disaster election period.
- Call 1-800-MEDICARE (633-4227) or 1-800-325-0778 for TTY users
- Call your Medicare broker
- Contact the insurance company that provides the Medicare plan you're interested in joining or leaving
You may use this election period to sign up or disenroll from any Medicare health plan. This includes Part D prescription drug plans and Part C Medicare Advantage plans. To compare the Medicare plan options in your area, just enter your zip code in our Find a Plan tool.
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