November 28, 2022
The Centers for Medicare & Medicaid Services (CMS) issued a ruling that implements changes to enrollment and coverage. These changes may make it easier for Medicare-eligible individuals to enroll using Special Enrollment Periods and help eliminate delays in Medicare coverage.
Changes to Special Enrollment Period eligibility
According to CMS, Special Enrollment Periods will now be available in Original Medicare (Parts A and B) for those who could not enroll due to certain conditions. This special enrollment change may make it possible for some individuals to receive Medicare Part B without paying late enrollment penalty fees.
Reducing gaps in Medicare coverage
Starting January 1, 2023, Medicare is reducing gaps in initial enrollment coverage. Individuals eligible for Medicare will now receive their Medicare benefits the month after enrollment. Previously, the start date of initial Medicare coverage was dependent on the month of enrollment.
For example, if you enroll in Medicare two or three months after turning 65, your Medicare coverage will not begin for three months after enrollment. This delay can cause gaps in healthcare coverage. Starting in January 2023, beneficiaries who sign up for Medicare after turning 65 can expect their coverage to kick in the month after enrollment.
What is a Special Enrollment Period?
A Medicare Special Enrollment Period (SEP) is a stretch of time when a Medicare beneficiary can enroll or change their coverage due to a qualifying life event. SEPs are used to alter Medicare coverage outside of traditional enrollment periods, such as the Annual Enrollment Period. Often, SEPs last two to three months.
What is an Initial Enrollment Period?
A Medicare Initial Enrollment Period is the seven-month window of time during which individuals eligible for Medicare can enroll. This enrollment period starts three months after one’s 65th birthday and ends three months after. The Medicare Initial Enrollment Period is most people’s first opportunity to enroll in a Medicare plan.