2 Ways Medicare Enrollment May Change Soon

Medicare enrollee and doctor
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A bill that promises to help new Medicare enrollees passed the House of Representatives unanimously last week and is now before the Senate Finance Committee.

The Beneficiary Enrollment Notification and Eligibility Simplification Act, or BENES Act, contains two provisions that would benefit those signing up for Medicare for the first time.

Medicare is the federal health insurance program for people who are 65 or older or have certain disabilities.

New explanations of Medicare rules

Under the BENES Act, Americans approaching Medicare eligibility would receive advance notice about Medicare enrollment rules. This can be crucial, because misunderstanding some basic rules about Medicare can be costly.

For example, seniors who miss deadlines to enroll in Medicare face lifetime late-enrollment penalties. Perhaps the most hefty of these penalties is the one associated with Medicare Part B, which covers doctors’ services and other outpatient care. As we report in “4 Pitfalls for First-Time Medicare Enrollees“:

“Failing to sign up for Medicare Part B when you first become eligible generally triggers a permanent penalty. Your premiums could go up 10% for each 12-month period you waited to enroll — with that premium hike applying for as long as you have Part B.”

About 764,000 Americans currently pay this penalty, according to the Congressional Research Service. This increases their Part B premiums by an average of almost 30%.

If the BENES Act becomes law, Americans will receive notice about the enrollment rules in their Social Security statements before they become eligible for Medicare.


U.S. Rep. Jackie Walorski, R-Ind., one of the bill’s co-sponsors, said in a recent announcement:

“As more and more Americans reach Medicare age, it’s clear the enrollment process is overly complex, with simple mistakes resulting in costly penalties. We need to simplify the process and improve education to ensure seniors have access to the quality, affordable health care they deserve.”

Shorter Part B coverage gaps

The act also would mandate that Medicare Part B coverage begin during the first month after an individual first enrolls. This would “eliminate needless multi-month coverage gaps in Medicare enrollment periods,” Walorski said.

Currently, coverage is delayed for seniors who sign up for Medicare during the latter half of their initial enrollment period.

Walorski introduced the bill last year with U.S. Rep. Raul Ruiz, D-Calif., and U.S. Sens. Todd Young , R-Ind., and Bob Casey, D-Pa.

For more about Medicare, check out Money Talks News’ latest coverage.

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