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On November 20, 2023, the Federal Emergency Management Agency (FEMA) declared a disaster in Cook County due to the severe storms and flooding that occurred on September 17th and 18th. Medicare beneficiaries who are residents in affected areas and who have missed their Initial Enrollment Period due to the disaster are able to use the Special Enrollment Period for Emergency and Disaster proclamations to enroll into Medicare without any penalty. This SEP lasts until March 31, 2024.
SPECIAL ENROLLMENT PERIOD BACKGROUND
Due to the Consolidated Appropriations Act of 2021 Section 120 (Beneficiary Enrollment Simplification), multiple new Special Enrollment Periods (SEP) were established, including Special Enrollment Period for Individuals Impacted by an Emergency or Disaster. This Special Enrollment Period was intended to allow individuals who have missed their Initial Enrollment Period or any other enrollment period they were eligible for due to an emergency or disaster that has happened in their area. This applies to weather related emergencies and disasters declared by Federal, State, or Local government. Under this SEP, individuals have until the end of the 6 months after the end date of the emergency or disaster proclamation to enroll into Medicare.
DISASTER PROLAMATION
On November 20, 2023, FEMA declared a disaster in Cook County due to the severe storms and flooding on September 17-18, 2023. For more information on the disaster proclamation, click here.
HOW TO USE THE SEP
Individuals who qualify for this SEP must:
- Reside or have resided in counties mentioned in this alert during the time of the disaster proclamation or
- They rely on someone to make healthcare decisions that resides in one of the counties, such as the individual’s representative payee, legal guardian, Power of Attorney, or person providing care, and
- Were eligible for an election period. Ie Initial Enrollment Period, and
- Did not make an election during any other election period due to the disaster.
Once the individual enrolled, coverage will begin the first of the month following the month of enrollment.
Eligible individuals would need to call Social Security at 1-800-722-1213 to enroll into Medicare or fill out form CMS 10797-508. Click here to access the form.
Please note that the end date on the SEP form is 6 months after the end date of the disaster declaration. We have confirmed with Social Security and their POMS manual that the end date is at the end of 6 months after the end date of the proclamation. Click here to see the POMs.
Individuals may be asked to provide proof of residence in affected areas as well as proof of disaster proclamation. Accepted proof of emergency or disaster can be what the individual reports or the information for federal, state, or local government entities website. For more information on accepted proof of residence and emergency, click here.
If you have any questions, please feel free to email avisery@ageoptions.org
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