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Medicare beneficiaries who are residents of counties where Governor Pritzker has declared a disaster due to flooding from June 29th to July 4th and who have missed their Initial Enrollment Period are able to use the Special Enrollment Period for Emergency and Disaster proclamations to enroll into Medicare without any penalty. This SEP lasts until January 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 PROLAMATIONS
On July 11th, Governor Pritzker declared a disaster proclamation in Coles, Cook, Edgar, Hancock, McDonough, Morgan, Sangamon, and Washington counties due to severe storms and tornadoes for June 29th- July 4th. On July 24th, the disaster proclamation was extended to Calhoun, Christian, Clark, Cumberland, DeWitt, Logan, Macon, Monroe, Moultrie, Pike, Scott, and Vermillion Counties. Then on August 15th FEMA announced the approval of disaster declaration for Cook County for June 29th to July 2nd.
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 then 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.
Links to the proclamations can be found below:
Original Proclamation: https://www.illinois.gov/content/dam/soi/en/web/illinois/documents/government/june-to-july-2023-storm-dis-proc-07-11-23.pdf
Expanded Proclamation (added 13 counties): https://www.illinois.gov/news/press-release.26748.html
If you have any questions, please feel free to email avisery@ageoptions.org
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