Clarification for the Disaster SEP Duration Update
Additional clarification on the recent SEP Duration update has been provided.
For Medicare Advantage Plans, we are still to follow the guidelines in the 42 CRF, Subchapter B, Part 422 - Medicare Advantage Program, guidance, Sec. 422.62(b)(18), and For Part D, Part 423. Both apply the 2 month, etc. guidance. This is also referenced in the MMCM, Chapter 2 Enrollment and Disenrollment (p. 46). What is in Part 406 does not supersede the guidance in Part 422. For reference, you can view the information here.
Below is the original messages we posted:
Based on the recently released final rule document, CMS has extended the length of SEPs that are based on Federal, State, or Local Emergency/Disaster Declarations. Whereas previously, the guidance allowed the SEP to last the entire incident period plus two months after the end date of the incident period (per 42 CFR 406.27 and 42 CFR 407.23), the SEP is now available until six months after the end of the incident period. This update applies to all declarations that were made after January 1, 2023.
Visit Messer's Medicare Certifications & Information page in the Agent Center to view active SEPs. An SEP may be granted to individuals that reside in an affected service area where a Federal, State, or Local Government Entity has declared a State of Emergency impacting individuals in a specific geographical area. The declaration allows for a one-time SEP in the event an individual was unable to make an election during another qualifying election period.
If you have any questions, call us today at 866-568-9649!