The SEP begins April 1, 2014, and ends March 31, 2015.
An EHH Medicare beneficiary is eligible for the SEP if he or she is not currently
entitled to SMI, resides in one of the ZIP codes listed in HI 00803.200B, and is not currently in an initial enrollment period (IEP), see HI 00805.275 and HI 00803.060.
EHH Medicare beneficiaries who previously resided in one of the ZIP codes listed in
HI 00803.200B but currently do not live in one of the specified ZIP codes are not eligible for
the SEP. Beneficiaries whose EHH Part A (Hospital Insurance, HI) entitlement date
is December 2014 or later are not eligible for this SEP because they are still in
their IEP as of the end of the SEP. If these beneficiaries do not enroll during their
IEP, they may only enroll during the general enrollment period, other applicable SEP,
or subsequent IEP, see HI 00805.010.
The SMI application for the EHH SEP must be filed between April 1, 2014, and March
31, 2015. The SMI effective date is the first day of the month following the month
the SMI application was filed. To determine when we consider a mailed application
for SMI filed, follow the rules in HI 00805.130.
There is no premium surcharge for enrollment during the SEP and no retroactive entitlement
to SMI. In addition, if the EHH Medicare beneficiary enrolled in SMI during the SEP
and SMI later terminates, he or she may reenroll in SMI using the SEP if the application
is filed by March 31, 2015. The SMI effective date is based on the month of the second
Northeastern Program Service Center (NEPSC) will send a letter with a brochure about
the pilot program and a modified form CMS-40B and a courtesy return envelope to EHH
Medicare beneficiaries not enrolled in SMI who currently reside in the ZIP codes listed
in HI 00803.200B. See attached copies of the outreach letter and modified form CMS-40B.