Medicare SEP for Those Affected by COVID-19; June 30 Deadline

May 20, 2020

What’s new: If any of your clients have missed their Medicare enrollment period due to the COVID-19 pandemic, CMS is providing a Special Enrollment Period (SEP).

Bottom line: The SEP allows individuals with a Medicare enrollment period beginning March 1, 2020, or later to enroll in, disenroll from, or switch Medicare health or prescription drug plans, even if they missed other enrollment periods. Affected individuals need to complete their special enrollment by June 30, 2020. 

This is available to Medicare beneficiaries who:

  • Reside, or resided at the start of the incident period, in one of the 50 states, tribes, territories and the District of Columbia;
  • Had another valid election period at the time of the incident period (March 1, 2020, to June 30, 2020); and
  • Did not make an election during their other valid election period.

Top tips: Eligible beneficiaries get one opportunity to make the missed election with this SEP. Beneficiaries are not expected to provide proof that they were affected by the pandemic-related emergency.

MAPD/PDP enrollment: While you can help your clients enroll via a paper application, we strongly encourage using online channels. For Medicare Advantage with Prescription Drug Plans (MAPD) and Medicare Prescription Drug Plans (PDP), complete and submit online applications via Blue Access for ProducersSM. After logging in, click on the Medicare icon and choose the “Plan Select & Enroll” tool to begin. 

Enrollment application tips: 

  • Under the enrollment period eligibility section in the MAPD/PDP paper and online applications: Select the option that reads, “I was affected by a weather-related or major disaster as declared by the Federal Emergency Management Agency (FEMA). One of the other statements here applied to me, but I was unable to make my enrollment because of the natural disaster.”
  • For the paper application: Under the “Office Use Only” section, enter 03/01/2020, 04/01/2020, 05/01/2020 or 06/01/2020 for “Effective Date of Coverage.” In the same section, check the “SEP” box and next to “(type)” enter “DSP”.

Resources: For more information, see the following: