New Benefits & Special Enrollment Period (SEP) During a National Emergency

Since President Trump declared COVID-19 a national emergency in all 50 states and the District of Columbia, a Special Enrollment Period (SEP) for Medicare beneficiaries is allowed. The SEP runs from March 1st to June 30th.

What is a Special Enrollment Period?

The SEP exists for Medicare beneficiaries who were unable to make an election during the Open Enrollment Period (OEP), including both enrollment and disenrollment decisions. If an enrollee did make an election decision during OEP, they are not eligible for the SEP.

SEPs present a unique opportunity for Medicare Advantage (MA) plans to capture new enrollees. However, this effort may be best left to the sales team. The number of Medicare beneficiaries taking part in this new SEP is most likely lower than the OEP, so it would be difficult to achieve a high return on any new marketing investment.

New Benefits During a National Emergency

In addition to the SEP, MA plans may offer additional benefits during a federal or public health emergency. There are a variety of benefits that can be offered, but they must be offered uniformly to all plan members. Here are a few examples:

  • Introduce an OTC benefit or increase an existing OTC benefit allowance. (Must be health related, unless part of Supplemental Benefits for Chronically Ill Enrollees [SSBCI].)
  • Waive the plan premium
  • Offer new mandatory supplemental benefits, such as meals or transportation
  • Provide a cell phone and/or tablet. (Again, this must be for health-related services only, unless part of SSBCI and there is a reasonable expectation of improving or managing the health or overall function of the chronically ill member.)
  • Decrease and/or eliminate copays/coinsurance of any benefits

What Should Medicare Advantage Plans Do?

With the current COVID-19 environment, the upcoming deadline for bid submissions, constant communications with members, and navigating the new normal for AEP, it may be difficult for MA plans to consider a change at this time. However, introducing new benefits during this unprecedented time demonstrates your plan is committed to going above and beyond for its members. Just remember—if you decide to make changes and believe they are worthwhile, advertise them! You’re in an SEP, after all.

If you need help navigating this SEP or anything related to marketing through COVID-19 and a Presidential election year, contact us to start the conversation.

Diane Hollie
Diane Hollie

Diane Hollie Associate Vice President, Sales, Marketing & Strategy Diane Hollie is Associate Vice President of Sales, Marketing & Strategy at Convey Health Solutions (Convey). In this role, she provides strategic consulting services to ensure organizations maximize their sales distribution and marketing mix. Diane brings Convey clients more than 20 years of experience in marketing, sales, and product development for Government programs. Her strong marketing, sales and compliance background has extended to providing compliance guidance for marketing, sales and customer service communications. Since joining Convey, Diane has worked with numerous clients to meet and exceed their enrollment goals, maximize their market potential with strong competitive products and develop marketing and sales strategies to improve market share within the ever-changing Centers for Medicare & Medicaid Services (CMS) compliance guidelines. Many of Convey’s clients have turned to Diane to provide marketing analysis, marketing and sales plan development and operational assessments of marketing, and marketing compliance and sales areas. She is fluent in developing the working tools and training programs for future success within the market and with CMS. Diane has published several articles providing marketing and sales guidance within the Medicare Advantage market.

No Comments Yet

Leave a Reply

Your email address will not be published.