CMS Extends Important Relief Opportunity, Creates Permanent Fix for those Affected The Centers for Medicare & Medicaid Services (CMS) recently announced a year-long extension, through September 30, 2019, of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed Medicare enrollment. The agency also agreed to develop a more permanent solution for people who are affected. Under this policy, people who are eligible for Medicare and have Marketplace coverage can apply to enroll in Medicare Part B without penalty. Those who have already transitioned to Medicare can request that any Part B late enrollment penalties they may have received be reduced or eliminated. The year-long extension is
welcome news to those who are eligible but have not yet learned about or successfully accessed this opportunity, as well as those who are currently relying on incomplete or inaccurate federal materials to understand how the Marketplaces and Medicare interact and make an informed enrollment choice. Importantly, CMS’s decision to clarify that there is no time limit on the availability of equitable relief for those who are eligible will allow those affected to apply for that relief at any point in the future. As recently discussed, the Medicare Rights Center recently joined nearly 80 national and state organizations in urging
CMS to take these steps. We applaud the agency’s decision to heed the call of consumer advocates, insurers, and health care providers who agreed these changes were necessary to improve the health and economic security of people with Medicare and their families. Medicare Rights looks forward to working with our agency partners, State Health Insurance Assistance Programs (SHIPs), local Social Security Offices, and others to help people access this critical relief. For more information about equitable relief for Marketplace enrollees and how to apply, see Medicare Rights’ online resource, Medicare Interactive,
and: Read the Fact Sheet updated by CMS Read the Social Security Agency’s Emergency Message reflecting these policy changes Call the Medicare Rights Center’s free national helpline at 1-800-333-4114 Call the State Health Insurance Assistance Program (SHIP) at 1-877839-2675 or visit the shiptacenter.org Contact the Social Security Administration at 1-800-7721213, or go to socialsecurity.gov, or visit your local Social Security office.
Responding to Advocates, CMS Makes Needed Changes to the 2019 Medicare & You Handbook This summer, the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, released a draft version of the annual “Medicare & You” Handbook that contained several glaring inaccuracies that alarmed advocates, including Medicare Rights. The agency recently released the final 2019 Handbook, which addresses many of our concerns. The handbook is an official government publication that is designed to provide people with Medicare with information about the Medicare program, their choices for obtaining coverage, and the benefits they can expect. Distributed to millions of homes each year, it is one of CMS’s most widely accessed resources among people with Medicare. In response to the draft Handbook, in May Medicare Rights joined the Center for Medicare Advocacy and Justice in
Aging to send a letter to CMS to point out our observed inaccuracies and request vital edits to ensure the information in the Handbook remains useful and objective. Importantly, the letter highlighted specific areas where the Handbook improperly promoted Medicare Advantage (MA) while downplaying the benefits of traditional Medicare. Our three organizations were invited to discuss the issue further with CMS and the resulting finalized 2019 Handbook is a significant improvement over the draft. This week, Medicare Rights, the Center for Medicare in Advocacy, and Justice in Aging sent another letter to CMS, this time expressing our thanks to the agency for its responsiveness to our concerns and for correcting the draft’s most serious errors in the final version.
We particularly appreciate CMS including in the final 2019 Handbook a revised comparison chart that more accurately outlines the differences between traditional Medicare and MA, in part by clarifying that access to providers is one of the most significant differences between the two coverage options. We also appreciate the agency removing several references in the draft that inaccurately cast prior authorization requirements in MA as an added benefit, rather than a utilization management tool that can hinder MA members’ access to services. We thank the agency for correcting these and other provisions, and for publishing a revised, more accurate Handbook. Doing so will put beneficiaries and those who help them navigate Medicare in a
better position to understand their options and make the best coverage decisions for their unique situations. While more can be done to improve future versions of the Handbook and other CMS materials on which people with Medicare rely, the revised 2019 Handbook is a strong first step. We look forward to continuing to work with our organizational partners and with CMS to ensure all of the agency’s communications to beneficiaries best achieve balance and objectivity, make Medicare understandable, and maximally support beneficiary decisionmaking. Read more about our original concerns with the “Medicare & You” Handbook. Read our thank you letter to CMS as a response to the changes to “Medicare & You.”
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