Your April Update

Reminder: CMS reversed decision on Medicare’s Disaster SEP

On March 20, 2025, the Centers for Medicare & Medicaid Services (CMS) reversed their decision to limit the availability of the Special Election Period (SEP) for Individuals Affected by a Government Entity-Declared Disaster or Other Emergency starting in April. You can continue Medicare disaster SEP business as usual through 2025 and beyond.

For details on disasters and other declarations, visit the Federal Emergency Management Agency (FEMA)

Encouraging PPO members to add a PCP to their account

A primary care provider (PCP) makes sure your clients get the care that is right for them and can help your clients avoid unnecessary expenses such as duplicate tests or higher out-of-network costs.

To ensure Access PPO members are realizing these advantages, we recently sent a series of communications to PPO members encouraging them to add their PCP to their online member account or call Member Services for assistance.

View text message for PPO members
View email for PPO members

We hope you can support this initiative by encouraging your PPO clients to add their PCP selection to their online account. The article below provides details on the advantages of working with a PCP.

OTC: New Scan to Pay feature

Now members have the option of using their mobile phone to pay for eligible OTC items at participating stores. Members can download the OTC Network app to access the Scan to Pay feature. With Scan to Pay, their OTC card will always be easy to access. It’s fast, convenient, and easy to use.

Applicable SCO enrollments

If you are handling SCO enrollments, remember that enrollments cannot be completed for individuals who are currently in short-term rehabilitation or residing in a long-term care facility. Members must be living in the community to qualify for enrollment.

This information is a key component of the SCO training. You can learn more and reference the slide deck here [click.harvard-pilgrim.org].

If you have any questions have not done a SCO training, or would like additional training, please reach out to Juraci Capataz, SCO Broker Relationship Manager at juraci.capataz@point32health.org.

For online training, click here.

Include your NPN and FMO on SCO enrollment forms

Don’t forget to complete the section below on the SCO enrollment form. Not only is this section important for enrollment purposes, but also for commissions. Remember to include your NPN and FMO.

Office Use Only:

Online Version: