What is the Medicare Special Enrollment Period?
Right now, we’re in Medicare’s Open Enrollment Period (OEP). But what happens if a major disaster strikes and you’re not able to take advantage of OEP? Don’t worry, you’ll still be able to change your plan if you need to. The Medicare Special Enrollment Period (SEP) extends the Medicare enrollment period during extenuating circumstances.
For example, you might find yourself in the midst of a life-altering weather event that prevents you from selecting coverage during OEP. Or you might need to move to a new state and discover that your previously selected coverage is not offered in your new state of residence. You can’t go without coverage, so a SEP allows you to choose a new plan.
Life changes, and sometimes your coverage has to change as well. SEPs can be difficult to understand, but we’re here to help you understand what you need to know about Medicare SEPs and how you can take advantage of this important enrollment period.
Am I eligible?
There are several circumstances for qualifying beneficiaries for SEPs. The most common are FEMA-designated natural disasters and changes in residence.
Extreme weather event or natural disaster
In order to initiate a SEP, the Federal Emergency Management Agency (FEMA) must officially declare an area affected by an emergency or a major disaster. This includes but isn’t limited to, extreme rain and flooding events, hurricanes, tornadoes, wildfires, man-made environmental catastrophe and more.
If you were planning to initiate or alter coverage during a predesignated enrollment period, like OEP, but weren’t able to because of the FEMA-designated disaster, you may take advantage of the SEP.
One extra benefit is that it doesn’t have to be you that lives in the disaster area to qualify. The SEP takes into consideration that many seniors rely on a family member to assist with their Medicare coverage selections. If the family member or caregiver charged with this duty lives in a FEMA-designated area, the same principle applies.
Change of residence
You may not have realized that moving can impact your Medicare coverage. For example, if you live in Arizona and selected a plan during last year’s OEP, but you now need to move to California to be closer to family, you will also need to also change your coverage. Different Medicare plans service different areas, and if you move into a state not serviced by your current plan, you’ll need to take advantage of this SEP.
You’ll want to take advantage of the SEP to find better coverage options in your new state that wasn’t available in your previous area of residence.
How long are SEPs?
The length of SEPs varies based on the circumstances. If you have a qualifying change of residence, you have two months to alter coverage. In the case of extreme weather or natural disasters, the SEP begins the day the disaster strikes and runs for four full calendar months thereafter.
This is almost always the case, but there have been a few cases when FEMA-designated SEPs were extended beyond four months. Hurricane Katrina, for example, made U.S. landfall on August 25, 2005 before pummeling the Gulf Coast for several days thereafter. The SEP for this natural disaster was extended through December 31, 2006—more than 16 months.
What can I change during SEP?
During SEP, you can enroll in, disenroll from, or switch Medicare health or prescription drug plan. Essentially, you can add, update, change, or drop both medical and prescription drug coverage during the SEP period.
Usually, if you need to take advantage of a SEP, you’re experiencing some significant life change. During these times, the last thing you want to worry about is your Medicare coverage.
If you need help or have questions about SEP, visit our website or call (877) 255-6273. You’ll be able to talk to a knowledgeable member of our team who will help you navigate SEP and find your best coverage options.
You may also seek assistance from Medicare by calling (800) MEDICARE (1-800-633-4227).