UPDATE: CMS Does the Right Thing, issues Special Enrollment Period for hurricane victims...
CMS Announces Special Enrollment Periods for Americans Impacted by Recent Hurricanes
Agency provides special open enrollment periods for 2017 Medicare and Exchange coverage
As a result of Hurricanes Harvey, Irma, and Maria, the Centers for Medicare & Medicaid Services (CMS) will make available special enrollment periods for all Medicare beneficiaries and certain individuals seeking health plans offered through the Federal Health Insurance Exchange. This important step gives these individuals and families who have been impacted by the hurricanes the opportunity to change their Medicare health and prescription drug plans and gain access to health coverage on the Exchange immediately if eligible for a special enrollment period.
“The lives of millions of Americans have been disrupted and impacted in some way by recent hurricanes,” said CMS Administrator Seema Verma. “Setting up special enrollment periods gives Medicare beneficiaries and individuals seeking coverage on the Federal Exchange the opportunity to access health coverage during this difficult time and when they need it the most. We remain committed to doing all we can to help support the areas and individuals affected by these historic and catastrophic hurricanes.”
CMS established the following special enrollment periods to support individuals impacted by hurricanes Harvey, Irma, and Maria:
- Medicare special enrollment period: This special enrollment period will allow individuals affected by these hurricanes to enroll, dis-enroll or switch Medicare health or prescription drug plans. It is available at the start of the incident period and runs through the end of the calendar year. Individuals may contact 1-800-MEDICARE to request enrollment using this special enrollment opportunity.
- Federal Health Insurance Exchange special enrollment period: CMS created this special enrollment period for certain individuals impacted by these hurricanes who need to enroll in a 2017 plan through the Exchange or make changes to their existing 2017 plan. This special enrollment period will apply to individuals who experienced a special enrollment period qualifying event between 60 days prior to the start date of the incident period and December 31, 2017, but were unable to complete the application, plan selection, and enrollment process due to a hurricane-related weather event in 2017. This special enrollment period will allow individuals impacted by the storms to select a new 2017 Exchange plan or make changes to their existing plan at any time through December, 31, 2017. Individuals affected by the storms may contact the Exchange Call Center at 1-800-318-2596 to enroll in a plan.
OK, let me hit the pause button for a minute to explain: While open enrollment for 2018 policies doesn't start until November 1st, keep in mind that some people with Qualifying Life Events (QLEs) are still able to enroll in policies for the remainder of 201.. For instance, let's say you lost your job (which had healthcare benefits), got divorced (and thus your family policy), gave birth (thus needing to add a dependent to your policy) or whatever earlier this month. If so, you're eligible to enroll in an ACA exchange policy for the last 3 months of the current year via a Special Enrollment Period (SEP) even though 2017 open enrollment ended back in January.
Normally you have a 60-day window to do this, which means if you lost your coverage/etc. on August 1st, you'd have until this Saturday (Sept. 30th) to utilize the SEP. Your new coverage would start effective Oct. 1st if you enrolled between 8/16 - 9/15, or on November 1st if you enroll between 9/16 - 10/15, and so on.
However, what if you live in Texas, Louisiana or Florida and had your home, financial records, etc. destroyed by one of the hurricanes and you're so busy dealing with putting your life back together that you simply don't have time to enroll via that 60-day SEP? What CMS is saying here is that you now have until as late as 12/31/17 to do so. I'm actually not quite sure why anyone would bother signing up for 2017 coverage in late December 2017, but whatever; the point is that hurricane victims who lose their coverage have until the end of 2017 to get coverage for 2017. This probably won't apply to too many people, but it's a good thing.
However, there's a more important additional SEP available for these folks as well:
In addition to the special enrollment periods for the 2017, individuals who reside in or move from areas affected by a hurricane in 2017 will be eligible for a special enrollment period that extends the 2018 Annual Open Enrollment Period through December 31, 2017. These individuals may contact the Marketplace Call Center at 1-800-318-2596 to request enrollment using this special enrollment period after December 15, 2017.
These special enrollment opportunities are in addition to the Medicare and Exchange annual Open Enrollment Periods this fall and any other enrollment period for which the individual may be eligible. CMS will continue to examine the circumstances in the areas affected by hurricanes and will consider taking action that reaches beyond December 31, 2017, if needed.
The 2018 Open Enrollment Period officially runs from November 1st, 2017 through December 15th, 2017 for coverage beginning on January 1st, 2018. CMS is adding an extra 16 days to the tail end of this for hurricane victims. As it happens, Texas, Louisiana and Florida (as well as Georgia and Mississippi, which I presume were also partially impacted) are all run through the federal exchange at HealthCare.Gov.
Not much else to add here other than in the midst of direct and blatant sabotage of the ACA Open Enrollment Period in a dozen other ways, the CMS division of the HHS Dept., at least, appears to be doing the right thing when it comes to hurricane victims.
Credit where due.
Now if they would follow up on this by bumpiing out Open Enrollment by at least 3 days for everyone else to make up for the 72 hours of suspiciously-timed maintenance time announced recently, restore the other 90% of advertising funds and 40% of outreach funding which they wiped out and have a change of heart about not participating in enrollment events, we'll be getting somewhere.
Health and Human Services Secretary Tom Price, M.D., declared public health emergencies in Texas, Louisiana, Florida, Georgia, South Carolina, Puerto Rico and the U.S. Virgin Islands – areas all impacted by hurricanes Harvey, Irma and Maria. With the public health emergencies in effect, CMS has temporarily waived or modified certain Medicare, Medicaid, and Children’s Health Insurance Program requirements to provide healthcare providers, facilities, and suppliers the flexibility they need so they can focus on the health and safety of those impacted by the hurricanes.
For more information on special enrollment periods for Medicare, visit:
- General guidance
- Beneficiary Information
- Provider Access
- More information on special enrollment periods for the Health Insurance Exchange
The agency continues to update its emergency page (www.cms.gov/emergency) with important information on its efforts to support hurricane response and recovery efforts.
UPDATE: Louise Norris wisely decided to take a look at exactly which areas of the hurricane-effected states will qualify for this particular SEP. Georgia and South Carolina are on the list of "public health emergencies" being declared...
Individuals will be considered “affected” and eligible for this SEP if they experienced an SEP qualifying event and attest that they reside, or resided at the time of the hurricane, in any of the counties declared as meeting the level of “individual assistance” or “public assistance” by FEMA.
And which counties are those? Norris looked it up and found the following:
TEXAS: Aransas, Austin, Bastrop, Bee, Brazoria, Calhoun, Chambers, Colorado, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Hardin, Harris, Jackson, Jasper, Jefferson, Karnes, Kleberg, Lavaca, Lee, Liberty, Matagorda, Montgomery, Newton, Nueces, Orange, Polk, Refugio, Sabine, San Jacinto, San Patricio, Tyler, Victoria, Walker, Waller, Wharton
FLORIDA: Alachua, Baker, Bradford, Brevard, Broward, Charlotte, Citrus, Clay, Collier, Columbia, DeSoto, Dixie, Duval, Flagler, Gilchrist, Glades, Hardee, Hendry, Hernando, Highlands, Hillsborough, Indian River, Lafayette, Lake, Lee, Levy, Manatee, Marion, Martin, Miami-Dade, Monroe, Nassau, Okeechobee, Orange, Osceola, Pasco, Palm Beach, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns, and St. Lucie, Sumter, Suwannee, Union, Volusia
GEORGIA: Camden, Charlton, Chatham, Coffee, Glynn, Liberty, McIntosh
LOUISIANA: As Norris notes, there aren't any counties actually listed...which seems odd to say the least, since Harvey hit Louisiana pretty hard...
SOUTH CAROLINA: None listed here either, although that's more understandable.