Special Election Period Extended to March 31, 2018

UPDATE: Special Election Period Extended to March 31, 2018, for Medicare Beneficiaries Affected by California Wildfires

The Centers for Medicare and Medicaid Services has extended the Special Election Period (SEP) for Medicare beneficiaries affected by the California wildfires to March 31, 2018.

Who is eligible?
Any beneficiary who resides in, or resided in, an area for which the Federal Emergency Management Agency (FEMA) declared an emergency or major disaster (see www.fema.gov/disasters or the list below*) is eligible for the SEP, if the beneficiary was unable to enroll in a plan during another qualifying election period. In addition, beneficiaries who do not live in the impacted areas but receive assistance from someone living in one of the affected areas also qualify for this SEP.

*FEMA declared an emergency or major disaster for the following counties:

• Butte
• Lake
• Los Angeles
• Mendocino
• Napa

• Nevada
• Orange
• Riverside
• San Diego
• Santa Barbara

• Solano
• Sonoma
• Ventura
• Yuba
     

What does this mean for beneficiaries?

  • Eligible beneficiaries who were unable to make a plan selection during the Annual Enrollment Period (AEP) have until March 31, 2018, to enroll in a 2018 plan. Eligible beneficiaries who wish to change their health and/or prescription drug plan, but were unable to do so during the Annual Enrollment Period (Oct. 15, 2017-Dec. 7, 2017), will now have until March 31, 2018, to enroll in a 2018 plan.
  • Eligible beneficiaries who were eligible for a different SEP, or aged into Medicare, but were unable to enroll during the allotted time period, will have their election period extended. Eligible beneficiaries who had/have a qualifying election period (e.g., aged into Medicare, are aging into Medicare or are qualified for a different SEP) but were unable to enroll in a plan during the allotted time, have until March 31, 2018, to enroll. Enrollments received are effective the first day of the following month. For example, if a beneficiary aged into Medicare and had until Dec. 31, 2017, to enroll but was unable to complete the enrollment process, the beneficiary can enroll now. If the beneficiary enrolls Jan. 29, the beneficiary’s plan will be effective Feb. 1, 2018.
  • Individuals with End-Stage Renal Disease (ESRD) have additional limitations that do not permit them to enroll in another MA plan, even if they are eligible for an SEP. If a member has ESRD, please discuss their options, since Original Medicare may be their only option if they leave their current MA plan.

Agent action
If a consumer contacts you as a result of this SEP, you may help them enroll in one of our plans and earn a commission. You must:

  • Ask the beneficiary for proof that the beneficiary resided in an affected area (e.g., driver’s license or utility bill reflecting the beneficiary’s address).
  • If the beneficiary is unable to provide proof, ask the beneficiary verbally if they attest that they lived/live in an area impacted by the wildfires.
  • Once you verify eligibility, you can proceed with the application.
  • You must use a paper application. Use the SEP election type code on the application, and write in Weather Related Emergency.

One-time SEP
Eligible beneficiaries can use the SEP one time. The SEP ends when the individual elects a new Medicare Advantage (MA) plan or when the SEP time frame ends, whichever comes first.
 
Additional Questions? Contact GoldenCare at 1-800-842-7799 and speak with your Regional Director.
 
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