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Carrier Updates

****** BREAKING NEWS from HUMANA******

A person must have had a valid election period during the time of the Incident Period that was missed in order to use this SEP.  AEP was not a valid election period during the Incident Periods listed below, so you cannot use this SEP simply because someone did not make an AEP election.

Attention:  Agents

CMS provides a Special Enrollment Period (SEP) for individuals affected by severe weather who need to enroll in, disenroll from or switch Medicare health or prescription drug plans and have missed another enrollment period (i.e., either aging in or a SEP) due to the weather event.  For those who qualify, the SEP begins on the first day of the incident period and runs for four (4) full months from the beginning of the incident period.    

Who qualifies for this special enrollment period?

This applies to individuals who:

  • Reside, or resided at the start of the incident period, in an area for which FEMA has declared an Emergency or a Major Disaster and has designated affected counties as eligible to apply for Individual or Public level assistance; and
  • Had another valid election period at any time during the incident period; and
  • Did not make an election during that other valid election period.

 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. Please note:  Affected counties can change on a regular basis.  Below is the list of eligible counties as of today.

 

Texas – Incident Period September 17, 2019 – September 23, 2019

SEP End Date – January 31, 2020

Chambers, Harris, Jefferson, Liberty, Montgomery, Orange, San Jacinto

 

South Dakota – Incident Period September 9, 2019 – September 26, 2019

SEP End Date – January 31, 2020

Aurora, Brookings, Brule, Charles Mix, Davison, Douglas, Flandreau Indian Reservation, Gregory, Hanson, Hutchinson, Kingsbury, Lake, Lincoln, McCook, Miner, Minnehaha, Moody, Sanborn, Turner, Union, Yankton, Yankton Indian Reservation

 

North Carolina – Incident Period September 1, 2019 – September 9, 2019

SEP End Date – January 31, 2020

Alamance, Alexander, Alleghany, Anson, Ashe, Avery, Beaufort, Bertie, Bladen, Brunswick, Buncombe, Burke, Cabarrus, Caldwell, Camden, Carteret, Caswell, Catawba, Chatham, Cherokee, Chowan, Clay, Cleveland, Columbus, Craven, Cumberland, Currituck, Dare, Davidson, Davie, Duplin, Durham, Eastern Band of Cherokee Indians of North Carolina, Edgecombe, Forsyth, Franklin, Gaston, Gates, Graham, Granville, Greene, Guilford, Halifax, Harnett, Haywood, Henderson, Hertford, Hoke, Hyde, Iredell, Jackson, Johnston, Jones, Lee, Lenoir, Lincoln, Macon, Madison, Martin, McDowell, Mecklenburg, Mitchell, Montgomery, Moore, Nash, New Hanover, Northampton, Onslow, Orange, Pamlico, Pasquotank, Pender, Perquimans, Person, Pitt, Polk, Randolph, Richmond, Robeson, Rockingham, Rowan, Rutherford, Sampson, Scotland, Stanly, Stokes, Surry, Swain, Transylvania, Tyrrell, Union, Vance, Wake, Warren, Washington, Watauga, Wayne, Wilkes, Wilson, Yadkin, Yancey

 

South Carolina – Incident Period August 31, 2019 – September 06, 2019

SEP End Date – December 31, 2019

Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Catawba Indian Reservation, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg, York

 

Georgia – Incident Period August 29, 2019 - September 7, 2019

SEP End Date – December 31, 2019

Brantley, Bryan, Camden, Charlton, Chatham, Effingham, Glynn, Liberty, Long, McIntosh, Pierce, Wayne

 

Florida – Incident Period August 28, 2019 – September 9, 2019

SEP End Date – December 31, 2019

Brevard, Duval, Flagler, Indian River, Martin, Nassau, Osceola, Palm Beach, Putnam, Seminole, St. Johns, St. Lucie

 

Florida Seminole Tribe – Incident Period August 28, 2019 - September 04, 2019

SEP End Date – December 31, 2019

Big Cypress Indian Reservation, Brighton Indian Reservation, Fort Pierce Indian Reservation, Hollywood Indian Reservation, Immokalee Indian Reservation, Tampa Reservation

 

Florida – Incident Period August 28, 2019 - September 09, 2019

SEP End Date – December 31, 2019

Alachua, Baker, Bay, Bradford, Brevard, Broward, Calhoun, Charlotte, Citrus, Clay, Collier, Columbia, DeSoto, Dixie, Duval, Escambia, Flagler, Franklin, Gadsden, Gilchrist, Glades, Gulf, Hamilton, Hardee, Hendry, Hernando, Highlands, Hillsborough, Holmes, Indian River, Jackson, Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Martin, Miami-Dade, Monroe, Nassau, Okaloosa, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, Santa Rosa, Sarasota, Seminole, St. Johns, St. Lucie, Sumter, Suwannee, Taylor, Union, Volusia, Wakulla, Walton, Washington

 

Puerto Rico – Incident Period August 26, 2019 - September 6, 2019

SEP End Date – December 31, 2019

Adjuntas, Aguada, Aguadilla, Aguas Buenas, Aibonito, Anasco, Arecibo, Arroyo, Barceloneta, Barranquitas, Bayamon, Cabo Rojo, Caguas, Camuy, Canovanas, Carolina, Catano, Cayey, Ceiba, Ciales, Cidra, Coamo, Comerio, Corozal, Culebra, Dorado, Fajardo, Florida, Guanica, Guayama, Guayanilla, Guaynabo, Gurabo, Hatillo, Hormigueros, Humacao, Isabela, Jayuya, Juana Diaz, Juncos, Lajas, Lares, Las Marias, Las Piedras, Loiza, Luquillo, Manati, Maricao, Maunabo, Mayaguez, Moca, Morovis, Naguabo, Naranjito, Orocovis, Patillas, Penuelas, Ponce, Quebradillas, Rincon, Rio Grande, Sabana Grande, Salinas, San German, San Juan, San Lorenzo, San Sebastian, Santa Isabel, Toa Alta, Toa Baja, Trujillo Alto, Utuado, Vega Alta, Vega Baja, Vieques, Villalba, Yabucoa, Yauco

 

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 at the start of the incident period.
  • If they do not have proof, ask them to verbally attest.
  • Confirm that they had another election period available during the time of the incident period.
  • 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.
  • On applications, use election code SEP DST. 

 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. 

Reminder:  These SEPs are only available to beneficiaries who were affected during the incident period and should not be used as a tool to generate new enrollments. 

 

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