UnitedHealthcare
Special Election Period Available to Members Affected by California Wildfires
The wildfires in California are causing disruption. The Centers for Medicare & Medicaid Services (CMS) has extended a Special Election Period (SEP) to Medicare beneficiaries affected by the fires. The SEP runs from the start of the incident through Dec. 31, 2017. UnitedHealthcare has provided the following information to exercise the SEP for Medicare plan enrollments.
Who is eligible?
Any beneficiary who resides in, or resided in, an area for which the Federal Emergency Management Agency (FEMA) has 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
- Mendocino
- Napa
- Nevada
- Orange
- Solano
- Sonoma
- Yuba
December 8th Southern California Wildfires
Additional counties in California will have a Special Election Period (SEP) available for Medicare beneficiaries affected by the California wildfires.
Special Election Period Overview
The wildfires in California have caused and continue to cause disruption. The Centers for Medicare & Medicaid Services (CMS) has extended a SEP to Medicare beneficiaries affected by the fires. The SEP runs from the start of the incident through Dec. 31, 2017.
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:
New counties added as of Dec. 8, 2017:
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What does this mean for beneficiaries?
Eligible beneficiaries who are unable to make a plan selection during the Annual Enrollment Period (AEP) have until Dec. 31, 2017, to enroll in a 2018 Plan. Eligible beneficiaries who wish to change their health and/or prescription drug plan, but are unable to do so during the Annual Enrollment Period (Oct. 15, 2017-Dec. 7, 2017), will now have until Dec. 31, 2017, to enroll in a 2018 plan. Enrollments taken between Dec. 8 and Dec. 31, 2017, are effective Jan. 1, 2018.
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 Dec. 31, 2017, to enroll. Enrollments received are effective the first day of the following month. For example, if a beneficiary aged into Medicare and had until Aug. 31, 2017, to enroll but was unable to complete the enrollment process, the beneficiary can enroll now. If the beneficiary enrolls Oct. 28, 2017, the beneficiary’s plan will be effective Nov. 1, 2017.
Verifications
- Individuals must show 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 if they attest that they lived/live in an area impacted by the wildfires.
- Once eligibility is verified, the application can proceed.
- Only paper applications can be used. Use the SEP election type code on the application, and write in Weather Related Emergency.
- If the enrollment is for 2017, the 2017 enrollment application must be used.
Annual Enrollment Period (AEP)
Please note that this Special Election Period is in addition to the Annual Enrollment Period. If beneficiaries in the impacted areas want to enroll in a plan, or change plans during AEP, with a Jan. 1, 2018, effective date, use the AEP election code, NOT the SEP enrollment code.
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.