Deadline Imminent for People in ACA Marketplace Plans to Enroll in Medicare without Penalty

— Advocates, Unions, and Insurers Urge CMS to Extend Relief Opportunity to Give Federal Agencies More Time to Ensure Updated, Accurate Information is Provided to Individuals Currently Making Enrollment Decisions — 

New York, NY— September 30, 2018 is the deadline to apply for the time-limited opportunity that allows some people who were—or are currently—enrolled in Affordable Care Act Marketplace plans to enroll in Medicare Part B and be relieved of any associated late enrollment penalties.

People eligible for “time-limited equitable relief,” as the opportunity is called by the Centers for Medicare & Medicaid (CMS), are permitted to:

• enroll in Medicare Part B without penalty, or
• get their Medicare Part B late enrollment penalty eliminated or reduced if they are already enrolled in Part B but delayed enrollment because they were enrolled in a Marketplace plan, also known as a Qualified Health Plan.

“The deadline is drawing near for people who are enrolled in Marketplace plans – but eligible for Medicare – to enroll in Medicare and be relieved of costly lifetime Part B penalties and gaps in health care coverage,” 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.

“This relief opportunity has been a lifesaver for older adults and people with disabilities who were not familiar with the Marketplace and Medicare rules. Yet, most are unaware of this reprieve, and others become discouraged from pursuing it after they receive misinformation from their local Social Security office,” said Baker.

People who make Part B enrollment mistakes can only enroll in Medicare during the General Enrollment Period which runs from January 1 – March 31, with coverage beginning July 1 of the same year.

Advocates, Unions, and Insurers Urge CMS to Extend the Deadline

The Medicare Rights Center along with nearly 80 other advocacy organizations and health insurers sent a letter to CMS today urging that it extend the relief period one more year, until September 30, 2019, or “until such time as the agency can demonstrate it has sufficiently corrected the outreach and education issues that continue to cause serious enrollment errors.” The letter also explains that “some of our organizations continue to see serious problems with the time-limited equitable relief application process” which is preventing some who are eligible from accessing this relief.

Individuals must contact the Social Security Administration to request time-limited equitable relief.

In the letter, advocates and health insurers also call for CMS to develop a “permanent relief pathway” for those who made an enrollment error during the period when misinformation was widespread.

When CMS first announced the time-limited relief opportunity in early 2017, the deadline was set for September 30, 2017. However, after the Medicare Rights Center, other advocates, and health insurers expressed concerns about delays stemming from a lack of awareness of the process, some not getting notification in enough time to pursue the relief, and others who might need this respite in 2018, CMS announced in October 2017 that it would extend the deadline to September 30, 2018.

“Fortunately, CMS recognized the critical need to provide relief to older adults and people with disabilities who mistakenly enroll in Marketplace plans instead of Medicare, but we know from calls to our helpline that we are not out of the woods yet,” says Baker. “The relief policy must be extended until we are certain that no one is shut out from this opportunity because they didn’t know about it or received misinformation when they tried to obtain it.”

For more information on time-limited equitable relief and how to apply, see Medicare Rights’ online resource, Medicare Interactive, and:

• Read the Fact Sheet made available by CMS
• Call the Medicare Rights Center’s free national helpline at 1-800-333-4114
• Call the State Health Insurance Assistance Program (SHIP) at 1-877-839-2675 or visit the shiptacenter.org
• Contact the Social Security Administration at  1-800-772-1213, or go to www.socialsecurity.gov, or visit your local Social Security office

Press Contact: Mitchell Clark – mclark@medicarerights.org

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