Exciting news! On March 20, 2025, the Centers for Medicare & Medicaid Services (CMS) reversed their decision to limit the availability of the Special Election Period (SEP) for Individuals Affected by a Government Entity-Declared Disaster or Other Emergency starting in April.
Health insurance agents and carriers can continue Medicare disaster SEP business as usual through 2025 and beyond.
If you made your clients or downlines aware of the SEP changes that were slated to take effect in April, be sure to update them that Medicare disaster/emergency SEP enrollments can continue as usual.
What’s Happening with the Medicare Disaster/Emergency SEP?
CMS retracted the Medicare disaster SEP changes they announced on December 3, 2024, which were scheduled to take effect April 1, 2025. In short, there will be no changes to the way Medicare beneficiaries can enroll using this SEP. They will not have to solely rely on 1-800-Medicare to enroll using a related SEP.
According to CMS’ March 20, 2025, memo, carriers should continue to accept applications using the Medicare disaster/emergency SEP. This means agents can continue to assist clients with utilizing the SEP and earning commissions for related enrollments through 2025 and beyond.
CMS states they’ll provide further guidance on the SEP enrollment process at a later date.
What Is the Disaster/Emergency SEP?
The disaster/emergency SEP is an enrollment period designated for beneficiaries who have been affected by a local, state, or federal state of emergency and missed their enrollment period. Beneficiaries who qualify can use this SEP to elect coverage for the first time, disenroll from their plan, or make changes. This SEP is active for the duration of the state of emergency and two months following the disaster or emergency.
To use this SEP, beneficiaries must have resided in the affected area or must rely on someone, for help with health care decisions, who resided in the affected area around the time of the incident. Additionally, the individual must have been eligible for another valid election period, but missed using it, around the time of the incident.
See a list of the latest emergency/disaster Medicare SEPs here
CMS’ decision to reverse the Medicare disaster SEP limitations is great news for agents! Now, you can continue to assist your clients using SEP and earning commissions for your work.
Not affiliated with or endorsed by Medicare or any government agency.
Share Post