You planned to change your Medicare Advantage plan before your enrollment deadline. Then a hurricane hit your area. You evacuated, lost power, or dealt with more urgent problems tied to the natural disaster. By the time things settled down, the deadline had passed.
You may still have an option. Medicare has special rules for certain people affected by government-declared disasters or emergencies. These rules don’t apply automatically to everyone who lived through the storm. But if you meet specific conditions, Medicare.gov says you may qualify for a Special Enrollment Period that gives you another chance to make the change you missed.
A Special Enrollment Period, or SEP, is a limited time when you can make certain Medicare changes outside the usual enrollment periods—including, in some cases, a chance to sign up for Medicare or sign up for Part B or Part D coverage you couldn’t complete on time.
According to the Centers for Medicare & Medicaid Services (CMS), people affected by a government-declared disaster or emergency may qualify for an SEP tied to that event. It can let you enroll in, switch, or drop a Medicare Advantage plan or one of the stand-alone prescription drug plans that make up Part D.
Because CMS’s rule covers any government-declared disaster or emergency, not just weather events, you may also see this described as the Medicare Emergency Special Enrollment Period. A disaster happening near you does not automatically create this SEP. You must meet CMS’s specific requirements, explained below.
CMS uses a three-part test. According to CMS, you may qualify if:
You don’t have to prove you were personally affected. CMS says you can attest that you lived in the declared area if your records were lost or destroyed.
This SEP also covers people outside the affected area who depend on a family member or caregiver there for help with Medicare decisions — including decisions about health insurance and prescription drug coverage.
Yes, but the declaration doesn’t have to come specifically from the Federal Emergency Management Agency (FEMA). According to CMS, a federal, state, or local government entity must make the declaration. That can include a presidential disaster declaration, a governor’s state of emergency, or a local government declaration.
Living through bad weather isn’t the same as having a qualifying declaration. You can check FEMA’s disaster declarations database for federal declarations, but state and local declarations can also count, and FEMA’s database won’t show those.
Medicare SEP eligibility is separate from FEMA disaster assistance. You don’t need to receive FEMA aid to qualify for this SEP, and receiving FEMA aid doesn’t automatically qualify you either.
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Local, licensed insurance agents with 25+ years of combined experienceA declaration alone isn’t enough. You must also have had a valid Medicare election period that overlapped with the emergency, and you must not have used it.
For example, say the Medicare Annual Enrollment Period was ending when a hurricane forced you to evacuate. If you missed your planned plan change, this SEP may give you another chance.
This SEP is not a general opportunity to change plans anytime you want. It is tied to the specific election period the emergency or disaster caused you to miss — and missing that window on your own could otherwise mean risking a late enrollment penalty for prescription drug coverage down the road.
According to CMS, this SEP generally runs for the length of the declared disaster or emergency, plus two months after the declared end date. If the declaration is extended, your window may extend too.
Every declaration has its own start and end dates, so your exact deadline depends on your specific situation. Don’t guess. Call 1-800-MEDICARE or (623) 223-8884 to speak with a local licensed Connie Health agent to confirm your deadline before your window closes.
According to CMS, this SEP may let you enroll in, switch, or drop a Medicare Advantage plan, with or without drug coverage. It may also let you join, switch, or drop a stand-alone Part D plan — helping you get or keep prescription drug coverage without facing an enrollment penalty for a gap you couldn’t control.
Which changes apply to you depends on the type of election period you missed. It can also matter whether you’re moving, or have already moved, outside your current plan’s service area because of the disaster — your licensed agent can confirm exactly which options you have and when a new health plan would take effect.
Agent tip:
“When you call 1-800-MEDICARE, have your disaster declaration area, the enrollment period you missed, and your current coverage details ready — the more specific you can be about why the disaster prevented you from enrolling, the faster Medicare can confirm your Special Enrollment Period.“
This SEP is separate from the Annual Enrollment Period, which runs every fall, or your first-time enrollment period, your Initial Enrollment Period. This SEP is only available to people who meet the disaster-related criteria above and only for the election they missed.
If you think a disaster or emergency caused you to miss a Medicare enrollment opportunity, call 1-800-MEDICARE (1-800-633-4227) before this SEP closes. Only Medicare can confirm whether you qualify and what your deadline is.
Before you call, it may help to have this information ready:
Calling doesn’t guarantee approval. Medicare will review your situation and let you know what options are available, and any approved change typically takes effect starting the month after you complete your request.
Need help understanding your Medicare Advantage options once your enrollment question is settled? Call (623) 223-8884 to speak with a licensed insurance agent.
If an emergency affected your area and you missed a Medicare deadline because of it, don’t assume the window is closed. Call 1-800-MEDICARE to confirm whether you qualify and how much time you have left.
A hurricane, flood, or other declared emergency doesn’t automatically reopen your Medicare enrollment window. But if you lived in a declared disaster area and missed a valid election period because of it, this Special Enrollment Period may give you another chance. Only Medicare can confirm your eligibility and deadline, so call 1-800-MEDICARE before assuming your window has closed.
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It’s a limited window that may let certain people affected by a declared disaster or emergency make a Medicare Advantage or Part D change they missed. It only applies if you meet the Centers for Medicare & Medicaid Services’ (CMS) specific requirements.
Not by itself. You must have lived in a declared disaster area, had a valid election period during the emergency, and missed it because of that emergency.
Check FEMA’s disaster declarations database for federal declarations, but state and local declarations can also qualify. Call 1-800-MEDICARE to confirm whether your situation meets the requirements.
Generally, the Special Enrollment Period runs for the length of the declared disaster or emergency, plus two months after it ends. Any change you make takes effect starting the month after you enroll, and your exact deadline depends on your declaration, so confirm it with Medicare.
Call 1-800-MEDICARE (1-800-633-4227). Only Medicare can officially confirm your eligibility, your deadline, and which plan changes you’re allowed to make.
Read more by Renee van Staveren
Since 2009, I've been writing about complicated, technical issues, with the goal of making topics like Medicare and healthcare easier to understand. I've been writing about Medicare since 2021 and healthcare since 2019. I am an AmeriCorps alumni. I enjoy gardening, reading, and DIYing.
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