SEP for qualifying Medicare beneficiaries in North Carolina

Special Enrollment Period (SEP) for qualifying Medicare beneficiaries in North Carolina

Overview of SEP during a declared disaster or other emergency

A special enrollment period (SEP) exists for individuals affected by a disaster or other emergency declared by a federal, state or local government entity who were unable to, and did not make an election during another valid election period. 

This SEP allows for enrollment and disenrollment elections. For more information, go to CY2024 MA Enrollment and Disenrollment Guidance. [Sec. 34.4(18)].

What you need to know about this SEP 

The SEP information provided below is based on an executive order by the governor of North Carolina on August 5, 2024.The SEP start and end dates are accurate as of the date of this communication.

Who's eligible? 

Individuals are eligible for this SEP if they:

• Reside, or resided at the start of the SEP eligibility period, described in this guidance, in an area for which a federal, state or local government entity has declared a disaster or other emergency. Or, they do not reside in an affected area, but rely on help making health care decisions from one or more individuals who reside in an affected area; and
• Were eligible for another election period at the time of the SEP eligibility period; and
• Did not make an election during that other valid election period due to the disaster or other emergency.

Enrollment instructions

IMPORTANT: Remember, you cannot use this SEP opportunity to proactively market to beneficiaries. However, you can assist any clients who contact you about this SEP.

• If an individual wants to enroll and believes they may qualify for this SEP, you need to ask the beneficiary if they can show proof that they lived/live in an impacted area at the start of the incident period. If they do not have proof, ask them to verbally attest.
   
• When helping eligible clients enroll, please select the weather-related or major disaster option in the Reasons for Special Enrollment Period Eligibility section of the application.  

Additional information 

If the incident end date of an emergency or major disaster is not otherwise identified, the incident end date is 1 year after the SEP start date; or, if applicable, the date of a renewal or extension of the emergency or disaster declaration, whichever is later. The maximum length of this SEP, if the incident end date is not otherwise identified, is 14 full calendar months after the SEP start date or, if applicable, the date of a renewal or extension of the emergency or disaster declaration.

Questions? We're here to help

If you have any questions, please contact your local Aetna Medicare Broker Manager for assistance. Login to Producer World to find contact information for Broker Managers in your state.