Hurricanes and Medicare: what a disaster declaration changes

Ian, Idalia, Helene, Milton: Florida has learned that a hurricane changes more than the roof. Medicare has a set of rules that switch on when the President or FEMA declares an emergency or major disaster, and they are worth knowing in June rather than in October.

The disaster Special Enrollment Period

If you were eligible to make a Medicare enrollment decision during a valid window — the Annual Election Period, the Medicare Advantage Open Enrollment Period, your Initial Enrollment Period, or another Special Enrollment Period — and a FEMA-declared emergency or major disaster kept you from making it, you get a Special Enrollment Period to make that decision afterward. It applies to people who live in the declared counties and to people who rely on someone in those counties to help them enroll, and it generally runs from the start of the incident until two months after it ends, or until the declaration is lifted. It does not give you a second bite at a decision you made on time; it gives you the bite you missed.

Prescriptions before, during and after the storm

Once an emergency is declared for your area, Part D plans must allow early refills (the “refill too soon” edit is lifted), must cover fills at out-of-network pharmacies when yours is closed, and must relax prior-authorization and step-therapy requirements for medications you were already taking. Get a refill as soon as a hurricane watch is posted — pharmacies close before the warning — and take the medication list with you. If you are on insulin, a refrigerated drug, or oxygen, tell your plan and your county’s special-needs shelter registry now, not in September.

Care when you have evacuated

Original Medicare and a Medigap policy work anywhere in the country, so an evacuee in Atlanta or Birmingham is covered as if at home. Medicare Advantage plans, during a declared disaster, must cover care from out-of-network providers at in-network cost-sharing when in-network care is unavailable, must waive referral requirements, and must not charge more than in-network rates. That protection ends when the declaration does, so if you stay away long, call the plan.

After the storm

If you lost your Medicare card or plan cards, Medicare.gov and your plan’s member site can replace them, and a pharmacy can usually look you up by name and date of birth. If your doctor’s office was destroyed and you had to change doctors, that is a network question we can help with. And if the storm made you rethink where you want to live, a move to another county opens its own Special Enrollment Period; see moving to Florida.

The go-bag list

• Medicare card, Medigap or Advantage card, Part D card (or photos of each on your phone).
• A current medication list with doses, and at least a two-week supply.
• Your doctors’ names and phone numbers, and your pharmacy’s.
• Your plan’s member-services number, 1-800-MEDICARE, and SHINE (1-800-963-5337).
• If you use a special-needs shelter, your county registration.