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March 20, 2025
That memo announced a change to how beneficiaries can make an election using the Special Election Period for Individuals Affected by a Government Entity-Declared Disaster or Other Emergency (Disaster/Emergency SEP) by requiring that they contact 1-800-MEDICARE to access the disaster/emergency SEP effective April 1, 2025.
We are withdrawing this memo and will provide further guidance on the SEP enrollment process at a later date. With this withdrawal, the proposed change in process will no longer go into effect on April 1, 2025. Plans should continue to accept applications using the Disaster/Emergency SEP and may continue to use enrollment forms and plan materials that include the Disaster/Emergency SEP.
For MARx submissions, the SEP reason code will remain “01.” For OEC crosswalk purposes, the S reason code via OEC will remain “DST.”
What is a Disaster SEP?
During the “Government Entity-Declared Disaster or Other Emergency” Special Enrollment Period (SEP) (previously known as the “FEMA-Declared Weather Related Emergency or Major Disaster” SEP), Medicare beneficiaries will have the opportunity to enroll in, disenroll from, or change their Medicare Part D or Medicare Advantage plan coverage.
This original CMS document shows that a declared disaster causes a Medicare SEP. This allows individuals an SEP to enroll in A or B of Medicare even if they have missed an enrollment.
If an individual lives in a declared disaster area, they may also be granted freedom of provider network restrictions and network pharmacy restrictions. In addition, they may also receive additional supplies of their prescriptions beyond the limit that is normally allowed.
A Disaster or Emergency Special Enrollment Period (SEP) begins on:
The Disaster or Emergency SEP ends after 2 full calendar months from the end date stated in the declaration, or, if different, the date that the end of the disaster or emergency is announced, whichever is later.
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