While most people newly eligible for Medicare are automatically enrolled in the program because they are receiving Social Security benefits at age 65, a growing number are not—and can face significant challenges in knowing how and when to do so. A recent article in The New York Times, “Why You Shouldn’t Wait to Sign Up for Medicare Part B,” highlights these complexities through the experience of Mr. Zeppenfeldt-Cestero, whose mistake in delaying Part B triggered punitive financial penalties and harmful coverage gaps.

The article also focuses the BENES Act (S.1909/H.R. 2575), in particular that it would help prevent enrollment mistakes by modernizing and simplifying the Part B enrollment process, and by sending notices to people who are approaching age 65 that clearly explain Part B enrollment.

Last week, the Department of Health & Human Services (HHS), the department of the federal government that oversees the Medicare program, previewed some changes it will be proposing for Medicare Part B prescription drug coverage. The administration claims these changes will lower the cost of Part B medications.

Most prescription drugs are covered under Medicare Part D, but a select number of drugs–usually ones that are administered by providers–are covered under Part B. These drugs tend to be very expensive and are generally used to treat serious conditions such as cancer, End-Stage Renal Disease, autoimmune disorders, or in the event of an organ transplant.

While Medicare Advantage (MA) plans are required to cover the same health services as Original Medicare, they are not required to offer the same level of provider access and can impose coverage restrictions—like prior authorization—that require enrollees to take additional steps before accessing prescribed care. If a service is covered “with prior authorization,” enrollees must get approval from the plan prior to receiving the service. If approval is not granted or sought, the plan generally will not cover it.

Pre-existing conditions have been prominent in the news lately and much of the discussion includes some misunderstandings about what it actually means to protect coverage of pre-existing conditions and why it matters. While Medicare and Medicaid cover pre-existing conditions and that coverage is not under threat, there are changes in laws and regulations, and even a pending court case, that do put coverage at-risk for millions of people in the United States who are covered by employer or individual insurance. Polling consistently finds that Americans want protections for pre-existing conditions, with 75% of the public saying it’s “very important” such protections remain law. But there is a lot of confusion about what this means.

Certain threats to health care seem to arise from the dead regularly, and this Halloween season features an assortment of such zombie threats to Medicare, Medicaid, and the Affordable Care Act (ACA). As 2018 winds down, we must remain vigilant about attempts to cut or eliminate these vital programs that help older adults, people with disabilities, and their families and caregivers.

Fall Open Enrollment is the time of year from October 15 through December 7 when you can change your Medicare coverage. You can join a new Medicare Advantage Plan or stand-alone prescription drug plan (Part D) plan. You can also switch between Original Medicare with or without a Part D plan and Medicare Advantage

Here are six things to keep in mind while you are choosing your Medicare coverage:

In late September, the Centers for Medicare & Medicaid Services (CMS)—the federal agency that oversees the Medicare program—released an overview of the upcoming year in Medicare Advantage (MA) and the Part D prescription drug program. Among the notable inclusions, CMS expects more people to join MA plans than ever before, shows a sharp increase in the number of plans available, and reveals the number of plans that will offer expanded supplemental benefits.

As policymakers debate next steps for expanding health insurance coverage and lowering health costs, some have introduced legislation that would broaden the role of public programs, such as Medicare and Medicaid. In light of recent characterizations of such proposals, the Kaiser Family Foundation (KFF) assessment of what these bills do (and do not do) is particularly important.

In the past two years, eight proposals were introduced, ranging from bills that would create a new national health insurance program for all U.S. residents, replacing virtually all other sources of public and private insurance (Medicaid-for-All), to more incremental approaches that would create a new public plan option, as a supplement to private sources of coverage and public programs.

This summer, the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, released a draft version of the annual “Medicare & You” Handbook that contained several glaring inaccuracies that alarmed advocates, including Medicare Rights. The agency recently released the final 2019 Handbook, which addresses many of our concerns.

The handbook is an official government publication that is designed to provide people with Medicare with information about the Medicare program, their choices for obtaining coverage, and the benefits they can expect. Distributed to millions of homes each year, it is one of CMS’s most widely accessed resources among people with Medicare.

The Centers for Medicare & Medicaid Services (CMS) recently announced a year-long extension, through September 30, 2019, of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed Medicare enrollment. The agency also agreed to develop a more permanent solution for people who are affected.

Under this policy, people who are eligible for Medicare and have Marketplace coverage can apply to enroll in Medicare Part B without penalty. Those who have already transitioned to Medicare can request that any Part B late enrollment penalties they may have received be reduced or eliminated.