May 16, 2018

Special Enrollment Period for Certain Hurricane-Affected Consumers


Update on Special Enrollment Period Available for Individuals Affected by 2017 Hurricanes and Hurricane-Related Weather Events

The Centers for Medicare and Medicaid Services (CMS) has identified consumers who were erroneously denied access to an Exceptional Circumstances Special Enrollment Period (SEP) and other flexibilities that were available for consumers affected by hurricanes and hurricane-related weather events that occurred in 2017, pursuant to Sept. 2017 guidance. Now CMS is notifying these consumers of eligibility for another SEP due to the error or misrepresentation of the Marketplace. These consumers will be able to select a 2018 Marketplace plan or make changes to their existing 2018 plan by May 24, 2018. Coverage accessed under this SEP will begin June 1st or July 1st, depending on the date the consumer selects their plan. Consumers wishing to access coverage prior to June 1st must file an appeal within 90 days of the date of SEP Eligibility Notice.

Who is Eligible?

Individuals who attested to residing in an area affected by a 2017 hurricane or hurricane related event who submitted an application within the last two weeks of December, but were not determined eligible for an SEP at that time, will be eligible for this new SEP. Per the September 28, 2017, guidance, an area is considered affected if it is a county meeting the level of "individual assistance" or "public assistance" by the Federal Emergency Management Agency (FEMA).

What Documentation is Needed?

CMS has identified the population eligible for this SEP within Marketplace systems so that they can be easily identified by the Marketplace Call Center representatives and other CMS officials. Anyone eligible for this SEP will receive a hard copy notice of this SEP in the mail. CMS will not require the submission of any documentation to prove eligibility for this SEP.

Steps to Helping a Consumer Access This SEP:

Eligible consumers can access this SEP directly through HealthCare.gov or through the Marketplace Call Center.

To pick a plan through HealthCare.gov, consumers should:

  1. Log into their Marketplace account.
  2. Select "Start a new application or update an existing one."
  3. Click on their name in the top right of the screen and choose "My applications & coverage."
  4. Select your current application. You'll see steps to continue to enrollment for anyone who was eligible to buy a 2018 Marketplace plan.

Note: Consumers will not be able to access this SEP through HealthCare.gov if they make changes to their online application. If a consumer has had changes to their application since they last applied, like changes to household income or family size, they should call the Marketplace Call Center at 1-800-318-2596 to update their information and enroll.