Medicare Rights Asks CMS to Ensure Important Relief Opportunity Is Available to Those Who Need It, Now and in the Future

Today, the Medicare Rights Center and a diverse coalition of 80 state and national organizations representing health plans, consumers, and advocates urged the Centers for Medicare & Medicaid Services (CMS) to retain a policy that helps some Medicare beneficiaries correct problems with their Part B enrollment resulting from confusion or misinformation with Medicare and the Affordable Care Act Marketplaces. Under this relief, Medicare-eligible individuals with Marketplace coverage can apply to enroll in Part B without penalty, and those who have already transitioned to Medicare can request that any Part B late enrollment penalties be reduced or eliminated.

In establishing this time-limited equitable relief policy in 2016, CMS was responding appropriately to the needs of Marketplace enrollees who became newly eligible for Medicare as the Marketplaces were being established and heavily promoted. Many of these enrollees inadvertently delayed or declined Part B because they were unaware of the financial penalties and coverage gaps that could result from choosing and/or keeping their Marketplace coverage. CMS subsequently extended this policy by one year, and recently expanded it to people with Marketplace coverage who did not enroll in Medicare during a qualifying Special Enrollment Period (SEP). For both populations, this important relief is set to expire on September 30, 2018.

Medicare Rights is extremely concerned that ending the policy this month would have serious consequences for people with Medicare. Although CMS has endeavored to improve the transitions between the Marketplace and Medicare, the confusion, misinformation, and resulting enrollment mistakes that led the agency to create this equitable relief pathway remain. On our National Helpline, we continue to hear from people who are experiencing significant problems with the time-limited equitable relief application process, and we remain troubled that current federal outreach and education strategies are preventing some who are eligible from learning about and accessing this relief.

In extending and expanding this policy in the past, CMS correctly recognized that barriers to understanding and navigating these coverage interactions endure. We agree with the agency’s assessments to date, and believe maintaining the policy as written for at least one year and developing of a more permanent solution is both warranted and appropriate.

“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,” said Joe Baker, president of the Medicare Rights Center. “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.”

Accordingly, in the letter, Medicare Rights joins our organizational partners in asking CMS to extend the availability of this relief until the agency can demonstrate it has sufficiently corrected the outreach and education issues that continue to cause serious enrollment errors—one year, at a minimum. The letter also considers the point at which the agency will have eliminated the current informational deficit, and encourages CMS to develop a permanent relief pathway for those who made an enrollment error during the period when misinformation was widespread.

Medicare Rights urges people who may be eligible for this relief to apply by the current September 30, 2018 deadline and to contact our National Helpline with any questions or concerns that may arise. For more information on time-limited equitable relief and how to apply:

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

Read the letter.

Read the press release.