SEP Notice for Medicare Eligible Enrollees Affected by COVID-19

SEP Notice for Medicare Eligible Enrollees Affected by COVID-19

At Medicare Portal, we continue to closely monitor the impact of COVID-19 on Medicare and are working hard to update you on changes as they happen. Recently, Centers for Medicare Services (CMS) changed their previous stance and made a decision to allow for a one-time Special Enrollment Period (SEP) for those affected by COVID-19. This SEP applies to all 50 states, tribes and the District of Columbia.

The COVID-19 SEP is for individuals that were unable to make an election during another qualifying enrollment period anytime between March 17, 2020 and June 17, 2020. You are eligible for this SEP if you were either making Medicare elections relating to enrollment or disenrollment. This includes Initial Enrollment Period (IEP), General Enrollment Period (GEP), or a Special Enrollment Period (SEP) – such as loss of employer coverage based on when employment ends – to apply for Part A and/or B or refuse Part B.

COVID-19 Special Enrollment Period (SEP) Eligibility

You will be considered “affected” and eligible for the SEP if you:

  • Reside, or resided at the start of the SEP period in an area declared an emergency or a major disaster by FEMA. If your county meets this criteria, you are eligible to apply for individual or public assistance; and
  • You had another valid election period at the time of the incident period; and
  • You did not make an election during this or any other valid enrollment period.

Additionally, the SEP is available to those who do not necessarily live in an affected area, but rely on someone who resides in an affected area to make their healthcare decisions. This includes friends and family members who live in affected areas.

Any enrollment made under this SEP will have an effective date of the 1st of the month following receipt of the enrollment request. Further, beneficiaries will not be expected to provide proof that they were affected by the COVID-19 pandemic.

NOTE: If you already have Part A and want to sign up for Part B, you cannot do this online. To enroll, you must complete form 40B and mail that to your local SSA office, indicating in remarks you are applying under the SEP for COVID-19.

For those who are receiving Social Security benefits prior to their 65th birthday and are in their IEP, you will be automatically enrolled in Parts A and B. However, should you desire to refuse Part B, you must do so within 60 days of receiving your IEP package. Instructions on how to refuse are in this packet.

If you are under a SEP due to loss of employer coverage, follow the guidelines regarding the 40B and the CMS -L564 forms, which include submission via mail or fax. See our previous posts or contact us for assistance.
For additional information from CMS, please see the attachment regarding enrollment changes under the COVID-19 SEP.

We want to assure you that Medicare Portal remains fully operational and committed to helping you during these unique times. If you are confused, or unsure of how to proceed with any aspect of your Medicare benefits, please contact our office at 703-214-4600, or email us at info@medicareportal.org. You can also find additional information on our website at www.medicareportal.org.

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