MAK-AIRS

 

The final rule (CMS-4199-F) can be downloaded from the Federal Register at:https://www.federalregister.gov/public-inspection/2022-23407/medicare-program-implementing-certain-provisions-of-the-consolidated-appropriations-act-2021-and

Section 120 of the CAA – Beneficiary Enrollment Simplification 

In general, under current rules for Medicare premium Part A and Part B, the date when an individual’s coverage becomes effective depends on when they enroll:

·         If an individual enrolls during any of the first three months of their Initial Enrollment Period (IEP), their coverage will start the first month of eligibility (e.g., age 65).

·         If an individual enrolls during their IEP in the month they become eligible, their coverage will start the month after they enroll. 

·         If an individual enrolls during any of the last three months of their IEP, their coverage will start 2-3 months after they enroll.

·         If an individual enrolls during the General Enrollment Period (GEP), which runs from January 1st through March 31st every year, their coverage will start July 1st.

As mandated in Section 120 of the CAA and finalized in this rule, beginning January 1, 2023, Medicare coverage will become effective the month after enrollment for individuals enrolling in the last three months of their IEP or in the GEP, thereby reducing any potential gaps in coverage.

Section 120 of the CAA also gave the Secretary the authority to establish SEPs in the case of individuals who meet such exceptional conditions as the Secretary may provide.  In this rule, CMS is finalizing SEPs that will provide individuals who meet certain exceptional conditions and who missed a Medicare enrollment period, an opportunity to enroll without having to wait for the GEP and without being subject to a late enrollment penalty (LEP).

~ submitted by Liz Yokley, BSW at Aging Matters