Special Election Period (SEP) in effect for Florida

Special Enrollment Period: Florida Emergency Declaration - Hurricane Idalia

Details:

Impacted Counties: Florida Statewide - Alachua, Baker, Bradford, Brevard, Calhoun, Charlotte, Citrus, Clay, Collier, Columbia,  DeSoto, Dixie, Duval, Flagler, Franklin, Gadsden, Gilchrist, Gulf, Hamilton, Hardee,  Hernando, Hillsborough, Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Nassau,  Orange, Osceola, Pasco, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns,  Sumter, Suwannee, Taylor, Union, Volusia, Wakulla

Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD or PDP plans until February 29, 2024

*Note: Eligible enrollments will be effective the first of the month after the application has been processed.

As a reminder, under current guidance, the SEP for a Government Entity-Declared Disaster or other  Emergency is available to individuals affected by an emergency or major disaster declared by a Federal, state, or local government entity and applies to disasters or emergencies initially declared January 1, 2021, and later. 

People are eligible for a Medicare SEP (DST) if they: 

• Lived in the affected area at the time. Members are also eligible if they did not live in the affected area, but relied on someone who does live there for help making health care decisions
• Were eligible for another election period at the time of the SEP eligibility period
• Had a valid election period, but did not use this election period due to the disaster or other emergency

The SEP starts as of the date the declaration is made, the incident start date or, if different, the start date identified in the declaration, whichever is earlier. The SEP ends two full calendar months following the end date identified in the declaration or, if different, the date the end of the incident is announced, whichever is later. Please review the Available SEPs chart on page 1 for the end dates for current SEPs.

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Enrollment Reminders

• Agents may not market SEPs; however, please be aware of all available SEPs in order to help beneficiaries who believe they missed an election period due an emergency or disaster
• When using an SEP, Agents should always:
• o    Ask the beneficiary if they can show proof that they live/lived in an impacted area at the start of the SEP eligibility period
• o    If the beneficiary does not have proof, ask them to verbally attest
• o    Confirm the beneficiaries had another election period available during the time of the incident period that they were unable to utilize due to the disaster or other emergency
• o    Once verified, use election code SEP-DST on the application
• o    If using Sales Connect, use “I was affected by a weather-related emergency or disaster (as declared by the Federal Emergency Management Agency (FEMA). One of the other statements here applied to me, but I was unable to make my enrollment because of the natural disaster” option.
• Be sure to review the required Pre-Enrollment Checklist with a beneficiary prior to enrollment. You should cover these items in full and confirm that the beneficiary understands all items addressed
• Remember to obtain Scope of Appointment (SOA) forms and only discuss products with potential enrollees that have been agreed to on the SOA
• You should review all health care choices with the beneficiary and help them to select a plan that best meets their needs and situation