Special Enrollment Period (SEP) is a time outside of the Initial Coverage Election Period (ICEP), Medicare Advantage Open Enrollment Period (MA OEP) and Annual Enrollment Period (AEP), where a member can make changes (enroll in, disenroll from or switch) to their Medicare Advantage (MA) or Medicare Advantage Prescription Drug (MAPD) plans.
An SEP may be granted to individuals that reside in an affected service area where a federal, state or local government entity has declared a state of emergency impacting individuals in a specific geographical area. The declaration allows for a one-time SEP, in the event an individual was unable to make an election during another qualifying election period
Eligibility Requirements:
An opportunity for a DST-SEP is ONLY available to beneficiaries who:
- Reside, or resided at the start of the SEP eligibility period described in this guidance, in an area for which a federal, state or local government entity has declared a disaster or other emergency or they do not reside in an affected area but rely on help making healthcare decisions from one or more individuals who reside in an affected area; and
- Were eligible for another election period at the time of the SEP eligibility period, and;
- Did not make an election during that other valid election period due to the disaster or other emergency.
Wellcare will communicate any changes or updates to these SEPs, if necessary, when they become available.
Please note: A recent CMS ruling regarding Disaster SEP duration extending to 6 months only applies to a member’s Initial Election Periods for Medicare Part A & B entitlement periods. See our recent communication for more details.
