What to Do When a Declared Emergency or Disaster Delays Your Medicare Enrollment

When there’s a disaster or a weather-related emergency in your area, you probably have a lot on your mind. First and foremost, you’re concerned about the safety of yourself, family members, friends, and pets. Next, you want to do everything you can to protect your home and property. 

Managing your health insurance is likely much lower on that list of priorities, even if you’re interested in enrolling in Medicare or changing Medicare Advantage plans. 

Once you are ready to address your healthcare coverage, you’ll need to understand how a declaration of a disaster or emergency by federal, state, or local authorities affects your ability to make Medicare elections. 

How an Emergency or Disaster Triggers a Special Enrollment Period 

As of January 1, 2023, the Centers for Medicare and Medicaid Services (CMS) enacted a rule change that allowed more people who are eligible for Medicare to take advantage of Special Enrollment Periods. That new rule could help if you miss a scheduled election period due to a disaster or emergency. 

A Special Enrollment Period (SEP) begins when the disaster or emergency is officially declared and applies to people who:  

• Lived in the area of the disaster or emergency when it started. 
• Were eligible for another enrollment period (such as the Initial Enrollment Period of seven months around their 65th birthday, the Annual Enrollment Period from October 15 to December 7, or the General Enrollment Period between January 1 and March 31) at the time of the incident. 
• Missed the valid enrollment period due to the declared disaster or emergency. 

An authorized representative, legal guardian, or caregiver who makes healthcare decisions for a Medicare-eligible person can also take advantage of this SEP if they live in an area where a disaster or emergency occurred. 

What Can I Do During This Special Enrollment Period? 

During this SEP, you may be able to make a variety of changes to your Medicare coverage like: 

• Enroll in Original Medicare — Part A (hospital insurance) and/or B (medical insurance) — for the first time. 
• Add a Medicare Part D prescription drug plan to your Original Medicare coverage. 
• Add Medicare Supplement insurance (Medigap) for expenses not covered by Original Medicare  
• Switch from Original Medicare to a Medicare Advantage plan offered by a private insurer, which usually includes Part D prescription coverage and other supplemental benefits. 
• Go back to Original Medicare from a Medicare Advantage plan. 

Your options can vary based on your situation and what enrollment period you missed. Any changes you make during the SEP will take effect on the first day of the month after you submit your request.  

When Does the Special Enrollment Period End? 

If you’re enrolling in Original Medicare for the first time, this SEP lasts until six months after the end of the declared emergency or disaster. For any changes to your coverage, the period continues until two months after the emergency or disaster is officially over.  

If you sign up for Original Medicare during this SEP, you still can choose to join a Medicare Part D prescription drug plan or switch to a Medicare Advantage plan during the two months after your Medicare coverage starts. Your enrollment in Part D or a Medicare Advantage plan will begin on the first of the month after you request the change. 

To explore your options and find a Medicare plan that meets your needs during this or any other Special Enrollment Period, connect with a licensed insurance agent for help. 

About GoHealth 

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.