BREAKING: CMS issues Hurricane SEP for former Puerto Rico / US Virgin Islands residents!

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Well THIS falls under the Good News department:

CMS Announces Additional Special Enrollment Periods to help Individuals Impacted by Hurricanes in Puerto Rico and the U.S. Virgin Islands
Agency provides extended special enrollment periods for 2018 Medicare and Exchange coverage

En español

The Centers for Medicare & Medicaid Services (CMS) announced additional opportunities for individuals affected by the 2017 hurricanes in Puerto Rico and the U.S. Virgin Islands to enroll in Medicare health and drug plans and health coverage through the Federal Health Insurance Exchange. CMS is providing these special enrollment periods so that certain individuals and families who were impacted can access health coverage on the Exchange and have additional time to join, drop, or switch Medicare health and prescription drug plans. CMS announced initial special enrollment period opportunities in September, this extends these opportunities through March 31, 2018.

“CMS is committed to making it as easy as possible for individuals and families whose lives have been disrupted by these hurricanes to access the healthcare coverage they need during this difficult time,” said CMS Administrator Seema Verma. “The impacts of a hurricane can last for months. These special enrollment periods provide the necessary flexibility for our beneficiaries to obtain and maintain coverage while dealing with the lingering aftermath of the storms. We will continue to monitor the circumstances in Puerto Rico and the U.S. Virgin Islands and will take additional action as necessary.”

CMS established the following special enrollment periods to support individuals impacted by the 2017 hurricanes in Puerto Rico and the U.S. Virgin Islands:

  • Federal Health Insurance Exchange special enrollment period: Individuals affected by the 2017 hurricanes in Puerto Rico and the U.S. Virgin Islands who relocated to a state that uses the Federal Health Insurance Exchange, but were unable to enroll during the 2018 Annual Open Enrollment Period or any other special enrollment period, are eligible for an exceptional circumstance special enrollment period to enroll in 2018 Exchange coverage. Individuals in this situation may request this special enrollment period through March 31, 2018. These individuals should contact the Exchange Call Center at 1-800-318-2596 to request enrollment using this special enrollment period.
  • Medicare special enrollment period extension: This special enrollment period will allow individuals affected by the 2017 hurricanes in Puerto Rico and the U.S. Virgin Islands to enroll, dis-enroll or switch Medicare health or prescription drug plans through March 31, 2018. This special enrollment period can be used even if the beneficiary made a choice during Medicare’s fall open enrollment period. The special enrollment period can also be used for those who left Puerto Rico and would like to enroll in a local Medicare Advantage or Medicare prescription drug plan that would better meet their healthcare needs. Beneficiaries who change their permanent residence, rather than temporarily relocate, and no longer reside in their plan service area, are eligible to join a Medicare Advantage or prescription drug plan offered in the new area in which they reside through the existing residence change special enrollment period. Individuals who were displaced and return to Puerto Rico or the U.S. Virgin Islands are also eligible for the residence change special enrollment period. Individuals in these situations may contact 1-800-MEDICARE to request enrollment using this special enrollment opportunity.

To be clear, this isn't quite as big a deal as it may sound like at first, for a couple of reasons:

  • First, any resident of PR or USVI who legally changed residences to any U.S. state or DC is already eligible for a 60-day Special Enrollment Period anyway...not because they lived in PR/USVI, but simply because they moved. That means that anyone who moves today has until March 18th to enroll for 2018 coverage, although it wouldn't start until at least March 1st at this point.
  • Second, this only applies to former PR/USVI residents who moved into one of the 39 states covered by HealthCare.Gov; if they moved to one of the 12 states which run their own exchange, they'll have to talk to that ACA exchange instead.

However, it's still important...again, for two reasons:

  • First: Hurricane Maria hit around September 20th or so. Normally anyone who lost coverage in mid- to late September would only have had until late November to use a "changed residences" SEP. I'm guessing the bulk of those who've moved to the mainland did so in October or November, and time would normally have run out for them by now.
  • Second: As it happens, guess which state is handled via the federal exchange at HealthCare.Gov? Florida, where around 300,000 Puerto Ricans have already relocated...as well as Texas, Georgia, South Carolina, Louisiana, Mississippi, Alabama and North Carolina, which I presume are among the other most frequent relocation states for PR/USVI residents.

I don't know many USVI residents have moved to HC.gov states, nor do I know the number of PR residents who've moved to other states (some have even moved to North Dakota, of all places...which is also on the federal exchange as it happens); let's call it an even 400,000 for now. And of course not all of those folks have officially moved; some may plan on returning soon. Finally, not all of those who do move will enroll via the individual market--some may have employer coverage, some will be on Medicare or Medicaid and so on.

Still, I'd imagine at least 100,000 or so people may find this 3-month SEP to be helpful in #GettingCovered whereever they've chosen to start their lives over again.