Instructions for assisting Medicare clients affected by recent weather-related emergencies or major disasters
As a reminder, the Centers for Medicare & Medicaid Services (CMS) is providing special enrollment period (SEP) for Medicare beneficiaries affected by weather-related emergencies or major disasters.
Please make sure you follow the instructions below before submitting these enrollments. On paper enrollment forms, make sure you indicate the SEP at the bottom of page 1. (Indicating the SEP on page 7 (Section 9, the AGENT USE ONLY section) is optional, but including it on page 1 is required.) Following these instructions will allow us to process the enrollment timely and accurately. Thank you!
Review Aetna’s recent communication for details about this SEP opportunity. You can also scroll down to review who’s eligible, impacted areas, and an example scenario when beneficiaries might use this SEP.
|Instructions for paper applications
If using paper enrollment forms, at the bottom of page 1, in the “Confirm your enrollment period” section, write in “OTH/SEP” and a description (i.e., “weather event in FL”), as shown at right.
Instructions for electronic enrollments
If submitting enrollments electronically with the Ascend Virtual Sales Office app, in the Confirming Your Enrollment Period section, check the “Other” checkbox and then enter a reason for using the SEP (i.e., “major disaster in TX”).
Who’s eligible for this SEP?
- Individuals who were eligible for an enrollment period but were prevented from making an election because of the declared disasters.
- Individuals who reside, or resided at the start of the incident period, in an area where FEMA has declared an emergency or a major disaster.
- Individuals who live outside of the affected areas but who rely on help making healthcare decisions from friends or family members who live in the affected areas.
- Beneficiaries impacted by Hurricanes Harvey, Irma and Maria—as well as beneficiaries affected by weather-related emergencies or natural disasters identified by the Federal Emergency Management Agency (FEMA) since September 29. (With the exceptions of these three hurricanes, the SEP is not available for disaster declarations that occurred prior to September 29.)
Beneficiaries who enrolled in a plan during the AEP are generally not permitted to make another election under this SEP unless they were eligible for a different enrollment period but couldn’t use it because of the disaster.
Based on the latest clarification from CMS, the impacted areas eligible for this SEP are below.
Click here to view a list of impacted counties where 2018 Aetna and Coventry MA/MAPD products are available.
Example scenario when beneficiaries might use this SEP:
Because of a recent natural disaster, a beneficiary had an enrollment period available but wasn’t able to review their 2018 plan options. Suddenly, it’s December 8 and AEP is over. Fortunately, the beneficiary is still eligible for this SEP through December 31, 2017, to enroll in a plan or change plans for 2018.
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