Changes to Beneficiary Use of a Government-Entity Declared Disaster/Emergency SEP
CMS Disaster/Emergency SEP Memo
This Memo announces a change to how beneficiaries can make an election using the Special Election Period for Individuals Affected by a Government Entity-Declared Disaster or Other Emergency (Disaster/Emergency SEP)
Beginning on April 1, 2025, individuals wishing to use the Disaster/Emergency SEO must call 1-800-MEDICARE in order to make an election. Medicare Advantage Organizations and Part D Sponsors will no longer accept elections directly from the beneficiaries using the Disaster/Emergency SEP. Plans will receive Disaster/Emergency SEP elections only via download from the Health Plan Management System (HPMS) Online Enrollment Center Management Module.
This change is in response to concerns that have been raised by plans about the misuse of the Disaster/Emergency SEP to enroll beneficiaries who were not affected by a declared disaster/emergency.
This change will be effective for all enrollment requests with an application date on or after April 1, 2025. To avoid applicant confusion, plans must remove the Disaster/Emergency SEP from enrollment forms and other enrollment mechanisms prior to this date.
If a plan receives an application using the Disaster/Emergency SEP with an application date on or after April 1st, 2025, the plan should treat the application as incomplete. The plan must reach out to the applicant to determine eligibility for another election period and to inform the applicant that they need to call 1-800-MEDICARE in order to use the Disaster/Emergency SEP. If the applicant is only eligible for the Disaster/Emergency SEP, the plan should deny the application for failure to provide the information to complete the application.
Plans should inform prospective applicants who may be eligible for the Disaster/Emergency SEP that they must call 1-800-MEDICARE in order to make an election under the Disaster/Emergency SEP. TTY users should call 1-877-486-2048.
For MARx submissions, the SEP reason code will remain “01,” however it will be moved to the “CMS approval required” group. For OEC crosswalk purposes, the S reason code via OEC will remain “DST.” Updates to the Plan Communication User Guide (PCUG) and more information from the MA-PD Help Desk will be released in the coming months. Additionally, we will update our model enrollment exhibits and descriptions of the SEP in the Medicare Advantage and Part D Enrollment and Disenrollment Guidance in 2025.
CMS will monitor OEC transactions and plan submissions in MARx to ensure plan compliance with this change.
Read the CMS release HERE.
Need help staying up to date with industry changes? Looking for support, technology and leads? Get in touch with Agent Boost Marketing to see how we can help you grow your career.
Looking for support in your career? We’re hiring agents! Get in Touch.
For more industry insights, follow the Agent Boost Podcast!
Get Contacted
With Agent boost Marketing, you get access to all of the following by contracting with us
I agree to terms & conditions provided by Agent Boost Marketing. By providing my phone number and email, I agree to receive text messages and emails from Agent Boost Marketing.
Where can I learn more about Agent Boost Marketing?
How long does the contracting process take?
How much commission will I receive and does Agent Boost Marketing take any of my commissions?
Get Contracted
Ready to take the next step towards leveling up your career? Looking for an upline that actually supports you with training, leads, tech, and more?
Get in touch with our contracting team.
Attend Our Webinar
Want to know more about the ways Agent Boost Marketing will help you?
Attend our free webinar where we answer common questions about contracts, carriers, commissions, tools, and more!
Upcoming Events
We're always looking for ways to support our agents with opportunities to learn, grow, network, and have fun! Our events are open to all!
Check out our past and upcoming events open to all agents!
A great place to start as an independent agent! Staff is friendly and caring! I have been here almost 2 years and plan on staying! I appreciate this company and love to work with them!
Learn More
These guys are great. They provide great support for their field agents and LOAs they have. They provide full transparency and do a great job at helping us do our job. They have great trainings multiple times a year, I enjoy working with them. They help me build a good business.
Learn More