As expected, CMS has provided Medicare Beneficiaries with a Special Election Period (SEP), as communicated on May 5th via an HPMS memo titled “ Special Enrollment Period (SEP) for Individuals Affected by a FEMA-Declared Weather-Related Emergency or Other Major Disaster: Applicable for COVID-19”
Although this SEP allowance is no surprise to those of us who have spent time working in Medicare Advantage, it is unique as it comes right after CMS has also allowed Medicare Advantage Organizations (MAOs) the ability to implement mid-year benefit enhancements due to the COVID-19 crisis (click here for more information).
Providing medical care for the vulnerable Medicare population in the safest way possible is the most important consideration at this time. However, a close second in the mind of most health plan executives is determining how to navigate these unprecedented changes to the Medicare landscape, while also ensuring that earned market share is maintained.
Following are five (5) recommended next steps in order to ensure your Organization is providing appropriate access to care, and communicating effectively to your membership:
If your organization has not implemented mid-year benefit enhancements per CMS’ guidance, act in real time to assemble the appropriate team members to do so.
Ensure that tele-doc visits and corresponding secure software are in place.
Create educational materials to provide to your members around what they can do each day to protect themselves (washing hands, using hand sanitizer, masks, etc.)
Create a dedicated customer service line that members can call if they are in need of support services (food, transportation, masks, gloves).
Create a series of communications to ensure that your beneficiaries feel the active support measures that your organization is taking, and understand both reduced cost sharing and enhanced mid-year benefit changes.
Contact us at email@example.com for 30 minutes (gratis) with one of our clinical, pharmacy or operations experts to discuss next steps for implementing CMS' updated guidance.
Click here to read the full HPMS memo titled “Special Enrollment Period (SEP) for Individuals Affected by a FEMA-Declared Weather-Related Emergency or Other Major Disaster: Applicable for COVID-19”