BENES Act Reintroduced in the U.S. House of Representatives

Congressmen Raul Ruiz, M.D. (D-CA.) and Patrick Meehan (R-PA) recently reintroduced the bipartisan Beneficiary Enrollment Notice and Eligibility Simplification (BENES) Act (H.R. 2575)—an act applauded by Medicare Rights. The BENES Act simplifies Part B enrollment periods and requires the federal government to provide advance notification to people approaching Medicare eligibility about enrollment rules and how Medicare works with other coverage.

“Too many seniors face an often daunting and confusing process when enrolling in Medicare Part B, which can lead to expensive penalties and higher long term costs. The bipartisan BENES Act will help older American and their families make informed decisions about enrolling in Medicare Part B, avoid costly mistakes during the process, and end barriers to care,” said Congressman Ruiz. “As a physician, I am dedicated to making sure seniors don’t fall through the cracks and ensuring everyone has access to the quality health care they need and deserve.”

People receiving Social Security benefits are automatically enrolled in Medicare Part B. Increasingly, however, many Americans are working longer, delaying retirement, and deferring Social Security benefits. Unlike those who are auto-enrolled, these individuals must make an active Medicare enrollment choice. Deciding whether and when to enroll in Medicare involves many complex rules, and inappropriately delaying Part B can lead to a lifetime of higher Part B premiums, gaps in coverage, and barriers to accessing needed care. The BENES Act seeks to address these challenges by improving complicated and outdated Medicare enrollment processes.

“Every day, some 10,000 Americans turn 65 and become eligible for Part B,” said Congressman Meehan. “But when older Americans reach enrollment age, they face a maze of rules, deadlines, fees, and penalties. The consequence of a mistake or missed deadline could mean higher premiums and other costs down the road. The BENES Act will ensure Medicare gives seniors advance notice and resources to help them better understand their Part B eligibility and avoid late enrollment penalties.”

The BENES Act is critical to solving many of the pitfalls associated with Part B enrollment. The 10,000 people who turn 65 daily will find enrolling in Medicare easier because of the BENES Act, and we urge lawmakers to work together to pass the legislation.Medicare enrollment rules are complicated and mastered by very few; thus, the BENES Act is a big leap in the right direction.

Key aspects of the bill include:

• Increasing Notification and Education. The BENES Act will create a pathway for the Department of Health and Human Services (HHS), Social Security Administration (SSA), and Internal Revenue Service (IRS) to work together and notify individuals approaching eligibility about enrollment rules and how other insurance works with Medicare.

• Eliminating Coverage Gaps during Enrollment Periods. The BENES Act guarantees that people with Medicare do not experience a break in critical coverage. Specifically, the bill will fix coverage gaps in the 5th, 6th and 7th month of a person’s Initial Enrollment Period (IEP) and in the General Enrollment Period (GEP), modernizing an enrollment system that has not been revisited since Medicare was established more than fifty years ago.

“Far too many people with Medicare are saddled with a lifetime of higher premiums and go without needed care due to a fragmented Part B enrollment system,” said Joe Baker, president of the Medicare Rights Center. “We welcome the BENES Act’s long-overdue reforms to the Part B enrollment process, and we applaud Congressmen Ruiz and Meehan’s leadership on this important cause.”

View a one-page description of the BENES Act.

Read the press release from Congressmen Ruiz and Meehan.