Consumer Advocates and Health Insurers Urge CMS to Provide Advance Notice to People with Marketplace Coverage Nearing Medicare Eligibility, to Avoid Coverage Gaps and Increased Costs

Washington, DC—More than 40 leading consumer advocacy organizations and health insurers sent a letter to the Centers for Medicare & Medicaid Services (CMS), urging the agency to develop a system to notify people with coverage through Marketplace plans about the ramifications of nearing Medicare eligibility.

“Adequate notice for older adults and people with disabilities in the Marketplace who are approaching eligibility for Medicare is altogether lacking,” said Joe Baker, president of the Medicare Rights Center, a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. “These notice gaps put Marketplace enrollees at risk for higher health care costs, gaps in health coverage, disrupted access to needed care, and tax penalties.”

The letter, signed by the Medicare Rights Center, AARP, America’s Health Insurance Plans, BlueCross BlueShield Association, and other leading voices, urges CMS to develop a system to adequately screen, notify, and educate individuals about how and when to seamlessly transition from their Marketplace coverage to Medicare. The letter emphasizes the need for advance notice on Medicare enrollment rules and the potential consequences of delayed enrollment.

“We appreciate that CMS is seeking input on how to facilitate smooth transitions from Marketplace coverage to Medicare,” said Baker. “As our letter shows, there is widespread agreement among consumer advocates and health plans that CMS must intervene to help people with Marketplace coverage avoid the pitfalls that accompany a mismanaged switch to Medicare.”

The letter was sent in response to CMS’ request for comment on unmet notification needs for Marketplace enrollees

nearing Medicare eligibility in the proposed Notice of Benefit and Payment Parameters for 2017.

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