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By Henry Ansah • December 12, 2018

SEP Notice for Individuals Affected by Hurricane Florence

Individuals affected by Hurricane Florence will have the opportunity to enroll in, dis-enroll from or switch Medicare health or prescription drug plans as the Centers for Medicare and Medicaid Services (CMS) will extend a Special Enrollment Period (SEP) to September's hurricane victims. The opportunity will be available in areas for which the Federal Emergency Management Agency (FEMA) has declared an emergency or major disaster. FEMA has determined those eligible are permitted for pubic or individual assistance. 

Who qualifies for this special enrollment period?

According to IGNITE with Humana,
• One must live or have lived in the residence at the time of the incident, in an area/county for which FEMA has declared an emergency or major disaster.
• Had another enrollment period at the time of the incident period (such as aging in or a SEP); and
• Did not enroll or make a change that other enrollment period.

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In addition, the SEP is available to those individuals who don’t live in the affected areas but rely on help making healthcare decisions from friends or family members who live in the affected areas.

What does this mean to agents?

If an individual wants to enroll and believes they may qualify for this SEP, agents should:

• Ask the beneficiary if they can show proof that they lived/live in an impacted area.
• If they do not have proof, ask them to verbally attest.
• Confirm that the beneficiary lived in a county that has been declared an emergency or major disaster and FEMA has determined is eligible for public or individual assistance.
• Once eligibility has been verified, proceed with the application.
• You can use an electronic or paper application.  Use SEP-OTH election type code and in the notes state: “DST - Missed election, FEMA emergency eff [Insert Date of Incident].”

Enrollments made pursuant to this SEP are effective the first of the month following the receipt of the enrollment request. For enrollment requests where more than one enrollment effective date is possible, agents will need to determine the applicant’s desired effective date.

For any updates to eligible counties, please refer to the FEMA website at: https://www.fema.gov/disasters.