From ACL--

 

Please see the message below from our CMS partners on guidance related to the existing Exceptional Circumstance Special Enrollment Period (SEP).

 

Every year there are Exceptional Circumstance SEPs granted to Medicare beneficiaries. This is not a new SEP.

·       The guidance for this SEP is no different than other years: call 1-800-MEDICARE and explain that they have an issue with their plan choice.   

·       There is no deadline for this SEP – they are available throughout the year. 

·       Because this is an Exceptional Circumstances SEP, only CMS is allowed to approve the SEP.

·       Beneficiaries only have to call in to 1-800-MEDICARE and explain their circumstances.  It isn’t our expectation that they will have documentation or screenshots. The call center representatives will assist with the rest of the process. 

 

CMS 11/27 Blog post:  https://www.cms.gov/blog/were-heading-last-week-medicare-open-enrollment-dont-miss-out-your-chance-find-better-coverage

 

In addition to the CMS guidance, a retroactive enrollment request can be made with an Exceptional Circumstance SEP for consideration following the process outlined above. A retroactive enrolment request is likely unnecessary with OEP enrollment actions. It may be useful throughout the year yet carries additional complexities with claims and premiums collections and reimbursements.

 

 

Brandy Bauer

Associate Director, Center for Benefits Access

Office: 571-527-3911

xxxxxx@ncoa.org

 

National Council on Aging

Improving the lives of millions of older adults, especially those who are struggling

251 18th Street South, Suite 500

Arlington, VA 22202

ncoa.org | @NCOAging

 

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