CMS Extends Needed Relief for People with Medicare Mistakenly Enrolled in Marketplace Plans

Fred RiccardiMedicare WatchLeave a Comment

This week, the Centers for Medicare & Medicaid Services (CMS) announced in guidance the phase out and extension of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed their Medicare Part B enrollment. Eligibility for this policy will sunset on June 30, 2020.

Under this time-limited policy—known as equitable relief—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.

By extending this policy, CMS is appropriately responding to the needs of people with Medicare. On our National Consumer Helpline, we continue to hear from people who are struggling to navigate Marketplace to Medicare transitions, or access equitable relief, due to inadequate or incorrect federal agency guidance.

CMS also announced plans to increase communication efforts to Medicare-eligible individuals about the risks of delayed Part B enrollment. In December 2019, CMS will launch a new monthly mailing sent to all Marketplace enrollees within a month of their 65th birthday. The mailing will notify them about important decisions related to their Medicare enrollment.

The Medicare Rights Center recently joined a coalition of nearly 80 state and national organizations in asking CMS to retain this important relief until the agency has sufficiently corrected the outreach and education issues that continue to cause serious enrollment errors. The continuance and improved communication strategy will give CMS additional time to put those guarantees in place.

We applaud CMS for doing right by people with Medicare. We look forward to working with our agency partners, State Health Insurance Assistance Programs (SHIPs), local Social Security Offices, and others to help people navigate these and other Medicare transitions, and to ensure all who qualify obtain needed relief.

Medicare Rights encourages older adults and people with disabilities who may be eligible for equitable relief to apply for this assistance, and to contact our National Consumer Helpline with any questions or concerns that may arise. Importantly, as CMS clarified last year and again today, even after the eligibility window closes on June 30, those who qualified for equitable relief while the policy was active can access it at any time in the future.

For more information on time-limited equitable relief and how to apply:

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