Examples of an appropriate and an inappropriate use of a disaster/emergency Special Enrollment Period (SEP)

Example: An appropriate use of a disaster/emergency SEP

Mr. X was eligible for a change of residence SEP due to his recent change in residence. Unfortunately, his new home was severely damaged by a wildfire shortly after his move. He was unable to enroll in a new Medicare Advantage plan during the election period. He is now eligible for a disaster/emergency SEP because:

• FEMA declared a weather-related emergency in his area, and
• Mr. X was unable to enroll in a new plan during the change of residence SEP. He is therefore eligible for a disaster/emergency SEP.

Example: An inappropriate use of a disaster/emergency SEP

Ms. X, a member residing in Portland, ME, and enrolled using the disaster/emergency SEP.  The use of this SEP was invalid because:

1. No disaster/emergency was declared in the Portland area at that time and
2. She had no other valid election period.   

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