Centers For Medicare & Medicaid Offers Updates to Lower Coverage Barriers, Simplify Medicare Enrollment, and Expand Access – InsuranceNewsNet


Baltimore, Maryland, April 23 — The US Department of Health and Social Services Centers for Medicare and Medicaid Services issued the following press release on April 22, 2022:

the Medicare and Medicaid Service Centers (CMS) released a proposed rule to update Medicare enrollment and eligibility rules that would expand coverage for people with Medicare and advance health equity. This proposed rule would provide Medicare coverage the month immediately following enrollment, thereby reducing the uninsured period and expanding access through Medicare’s Special Enrollment Periods (SEPs). It would also allow eligible beneficiaries to receive Medicare Part B coverage without a late enrollment penalty. This proposed rule would make it easier for people to enroll in Medicare and eliminate coverage delays.

“Health care isn’t just about fixing bones or handing out pills. It’s about giving people the peace of mind that comes with coverage when you need it,” said Health in the United States and Secretary of Social Services Xavier Becerra. “That’s why we’re proposing this rule today to help reduce delays, close gaps, and expand access to care for people with Medicare. The Biden-Harris administration will continue to strengthen Medicare and ensure that our older Americans and those living with disabilities or end-stage kidney disease get the affordable, quality health care they deserve. »

This is the first time that SEPs will be available for people who were unable to register due to exceptional conditions. It is also the first time that lifesaving coverage for immunosuppressive drugs will be provided to people who would otherwise lose all Medicare coverage. Together, these proposals not only implement important provisions of the Consolidated Appropriations Act of 2021 (CAA), but also support of President Biden Federal Customer Experience and Service Delivery Transformation Executive Orders for Rebuild trust in government and continues to strengthen Americans’ access to affordable, quality health care coverage by eliminating confusing wait times and allowing CMS and the Social Security Administration remedy missed registration periods by authorizing SEPs for exceptional conditions. In addition, these proposals support the Administration’s vision for CMS: to serve the public as a trusted partner and steward, dedicated to promoting health equity, expanding access to coverage and affordable care and improved health outcomes.

“CMS is committed to ensuring that people who are eligible for Medicare have timely access to this lifesaving coverage. This proposed rule, if finalized, will reduce the time it takes for people to receive Medicare coverage after enrollment and advance CMS’s strategic vision to expand access to affordable, quality health care and coverage,” said the CMS Administrator. Chiquita Brooks-LaSure. “CMS is grateful to Congress for allowing us to establish special enrollment periods for Medicare that will help eliminate coverage gaps and late enrollment penalties for those experiencing exceptional conditions. »

A SEP is an opportunity for people with Medicare to enroll in Part B if they did not enroll in Medicare during their initial enrollment period when they were first eligible. People with Medicare Advantage and Part D coverage can also use SEPs to make changes to their Medicare coverage when certain life events occur, such as moving or losing other insurance coverage. The rules about when people with Medicare can make changes to their coverage and what kind of changes they can make are different for each MS.

CAA Sections 120 and 402 made two key changes to Medicare enrollment rules. First, Medicare coverage will begin the month after enrollment for individuals enrolling during the last three months of their initial enrollment period or within the general enrollment period, reducing any potential gaps in coverage. . Currently, if people enroll in Medicare during the last three months of their initial enrollment period or the general enrollment period, they may have to wait several months before Medicare coverage begins. Second, the proposed rule also establishes a new immunosuppressive drug program that would extend Medicare immunosuppressive drug coverage to certain kidney transplant recipients. If finalized, the proposed rule will promote accessibility to life-saving medicines. This rule, if finalized, would come into effect January 1, 2023and implement changes made by the CAA.

“These proposals underscore CMS’s efforts to advance health equity and improve access to Medicare,” said Dr. Meena Seshamanideputy administrator of the CMS and director of the health insurance center. “Reducing coverage gaps, allowing special enrollment periods for people in exceptional circumstances, spending money smarter on kidney transplant patients – these are meaningful changes that put people at the center of their care and improve the Medicare program.”

Finally, CMS offers several technical updates to improve the administration of Medicare savings programs. These programs help make health insurance affordable for those struggling to pay for health care.

CMS encourages people approaching Medicare eligibility to research their Medicare coverage options and enrollment deadlines. and 1-800-MEDICARE are both available to help people understand their choices and associated timelines. In addition, personalized health insurance counseling is available free of charge from State Health Insurance Assistance Programs (SHIPs). To visit or call 1-800-MEDICARE for the phone number for each SHIP.


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