Medicare beneficiaries who have been impacted by the COVID-19 emergency will have access to a new Special Enrollment Period (SEP). Not everyone will qualify for this enrollment period, but for those who do, this is an important election opportunity.
The Medicare SEP
The Centers for Medicare & Medicaid Services (CMS) has announced a new Special Election Period (SEP) that is available for beneficiaries who were eligible for — but unable to make — an election because they were affected by the COVID-19 pandemic. This new SEP has been triggered out of a FEMA-declared emergency defined as weather-related emergencies or other major disasters. The COVID-19 SEP starts on March 1, 2020 and ends on June 30, 2020.
Medicare beneficiaries who are impacted by FEMA-declared weather-related emergencies or other major disasters are typically eligible for an SEP.
To qualify for the COVID-19 SEP, beneficiaries must reside in an impacted area (which in this case includes all 50 states). Additionally, they must have had another valid election period during the incident period but not used it to make an election during the incident period (beginning March 1).
Here are a few examples that would qualify:
- A client enrolled in an MAPD plan effective January 1 but was not able to make an election during the Medicare Advantage Open Enrollment Period (January 1 to March 31) should qualify.
- An individual who had an Initial Enrollment Period or General Enrollment Period during this time should qualify.
- Clients who moved during this incident period and were not able to enroll in a plan should qualify.
If you enroll a client during the SEP from March 1 to June 30, use election code SEP-DST. Please note that the SEP code that could be different per carrier
Enrollments made under the COVID-19 SEP are effective the first of the following month. If an earlier effective date is possible, talk to your client to find out the desired effective date (such as April 1 or May 1) and document the desired effective date on the enrollment form.
Reach out to Your Clients
The pandemic has been especially stressful for older individuals who are considered high risk for severe COVID-19. This includes Medicare beneficiaries.
- Medicare insurance agents should not use this SEP as a marketing opportunity to elicit new sales. However, it is important to let clients who are having trouble know that they have options.
- Take this opportunity to reach out to your clients and see if they need anything. If they have missed election opportunities because of the pandemic and are unhappy with their current coverage, help them take advantage of this new SEP opportunity.
- This is an opportunity to reach out, retain, engage, and inform your clients of their plan benefits and that they may be eligible to change. For example, most MAPD plans and Original Medicare have announced members are able to get COVID testing at no co-pay.
- With an election year upon us and this current pandemic, retaining your customers will be very important.