In late October 2022, the Centers for Medicare & Medicaid Services issued a final rule that will make it easier for older adults to enroll in Medicare and eliminate delays in coverage. The rule implements provisions included in the 2020 Coronavirus Aid, Relief, and Economic Security Act and the 2021 Coronavirus Response and Consolidated Appropriations Act, both of which were designed to implement economic assistance for both individuals and businesses in response to the pandemic.
After the final rule takes effect on Jan. 1, 2023, seniors will receive Medicare benefits the month after they enroll, instead of possibly having to wait months to receive coverage.
K. Katrice Daniels, a licensed health and life insurance broker and founder of Florida-based Insure Black America, said this was a needed change.
“I do applaud this administration for looking out for our seniors and trying to make things a lot easier and access to care for them better,” Daniels said.
The final rule also expands access to Medicare through special enrollment periods, allowing people to receive Medicare Part B coverage without a late enrollment penalty.
Medicare’s annual open enrollment period lasts until Dec. 7, and the final rule won’t affect that. It will help people who didn’t enroll during this period, however, if they meet certain qualifications. Special enrollment periods are now available for people who:
- Were impacted by a disaster or government-declared emergency
- Had an employer or health plan that misrepresented information related to timely enrollment in Medicare Part B
- Were incarcerated
- Will have Medicaid coverage terminated after the COVID-19 pandemic ends or on or after Jan. 1, 2023 (whichever is earlier)
Daniels said this change could have a large financial benefit for seniors by allowing them to receive Medicare benefits sooner. If people become sick before their insurance becomes effective, they’ll have to pay out-of-pocket. By creating the special enrollment periods and eliminating delays in coverage, seniors could potentially save a lot of money, Daniels said.
The majority of these changes don’t affect people already enrolled in Medicare. However, people with end-stage renal disease, a disease in which a person’s kidneys don’t work properly, are now eligible for Medicare Advantage Plans. The rule also establishes an immunosuppressive drug benefit for people who receive kidney transplants and would otherwise lose Medicare coverage. This allows people to receive funding for immunosuppressive drugs required after a kidney transplant to prevent the body from rejecting the kidney.
“These changes highlight CMS’ efforts to advance health equity and improve access to Medicare,” Dr. Meena Seshamani, deputy administrator of CMS and director of the Center for Medicare, said in a press release. “Reducing gaps in coverage, allowing for special enrollment periods for individuals in exceptional circumstances, spending money in a smarter way on kidney transplant patients—these are meaningful changes that put people at the center of their care and improve the Medicare program.”