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Questions with the Keyword SPECIAL ENROLLMENT PERIOD (SEP)
| Questions | Possible Answers |
|---|---|
| Are the beneficiaries who are outside the areas affected by the wildfires be eligible to enroll through the wildfire special enrollment period (SEP)? | The wildfire / natural disaster SEP is also available to individuals in CA who don’t live in the affected areas, but rely on help making healthcare decisions from friends and family members who live in affected areas. Plan sponsors may ask for proof of residence to determine if any individual resided in the affected area at the start of the incident period. They must accept an attestation if the applicant states that his/her documents were destroyed, or are inaccessible. |
| Once a beneficiary enrolls, when does the SEP become effective? | Coverage changes for any SEP will be effective the first of the month following the plan’s receipt of the enrollment request. |
| Do beneficiaries need to do anything to utilize the wildfire SEP? | CMS has advised that to qualify for this Special Enrollment Period, try to have paperwork that shows that you live in an affected area (like a driver’s license, utility bills, etc.). However, it is not mandatory that the beneficiary provides that proof. It is up to the beneficiary to attest that they were impacted to be deemed eligible. |
| How often can a beneficiary use the wildfire SEP? | Eligible beneficiaries can use this SEP once for each election period they missed. Individuals who made an election during the 2024 Annual Enrollment Period (AEP) cannot use the Wild/Natural Disaster SEP to make a second AEP election. |
| What is the enrollment deadline for the wildfire SEP? | Rules for getting health care may change for a short time if a disaster or emergency happens in your area. If you live in an area where an emergency or disaster has been declared by a federal, state, or local government, and that disaster or emergency kept you from signing up or switching or dropping plans during another qualifying enrollment period You might have a Special Enrollment Period (SEP) to join, switch, or drop your plan |