Final Rule for Part B Enrollment Changes

[kgmom219]

Lots of SEP options, including begging.

Enrollees in the month of their IEP and the 3 months after will get covered the first of the next month. So no more of that PITA game.

During the GEP, its first of the next month.

Outside of GEP, you are waiting until Feb 1 of the following year. (This was not the intent of the law. I want to know who screwed up with the final language. This is EXACTLY what was supposed to be fixed.)

Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and other Revisions to Medicare Enrollment and Eligibility Rules (CMS-4199-F) | CMS

 

[sshafran]

Enrollees in the month of their IEP and the 3 months after will get covered the first of the next month. So no more of that PITA game.

Have not read it (busy morning) but what would be NICE would be having a "requested Part B effective date" even during IEP, like they do on the SEP applications.

So many people turning 65 are retiring 1 mo, 2, mo, 3 months... whatever after T65 but telling them,

"Ok, you turn 65 in March. You retire March 10th and EGHP extends thru March. So you need April 1. OK, apply on March 1 for Medicare, and they'll give it to you effective 4/1 and we'll hope and pray that you get your MCID in time, no glitches, towards the end of March and our schedules will align to do your application(s)."

Often I'll tell people just to do it 1 month early and bite the bullet and pay the extra for less stress.

 

[DonP]

So the new gep is only Jan 1- march 31 for next month coverage ? It looks like disaster code sep’s are being extended to 6 months now . Hell people cam move yr round in mapd now .

 

[Chazm]

Lots of SEP options, including begging.

Enrollees in the month of their IEP and the 3 months after will get covered the first of the next month. So no more of that PITA game.

During the GEP, its first of the next month.

Outside of GEP, you are waiting until Feb 1 of the following year. (This was not the intent of the law. I want to know who screwed up with the final language. This is EXACTLY what was supposed to be fixed.)

Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and other Revisions to Medicare Enrollment and Eligibility Rules (CMS-4199-F) | CMS

I skimmed the article but didn’t immediately see where they can’t start it any month after applying.
what paragraph is that in?


There’s a link in the article and the graph literally says any month you enroll in Medicare, it will start the next month. That said, it’s around 100 more pages I don’t want to read.

Can anyone confirm that? And quote it?

 

[LostDollar]

There’s a link in the article and the graph literally says any month you enroll in Medicare, it will start the next month. That said, it’s around 100 more pages I don’t want to read.

But there seems to be a limit to what months you can enroll in Part B.

 

[LostDollar]

Caveat, not an agent.

The quote below suggests that people can only apply for Part B within specific timeframes.

Individuals may apply for Part A at any time, but can only apply for Part B during a specific enrollment period (IEP, GEP, or SEP).

[EXTERNAL LINK] - Federal Register :: Request Access

Those timeframes seem to be covered by the new "first of following month" rules.

 

[LostDollar]

[EXTERNAL LINK] - SSA - POMS: HI 00805.010 - Rules on Enrollment Periods - 10/31/2022

(POMS Manual on 11/20/2022
HI 00805.010 Rules on Enrollment Periods)

Specific times for enrollment
The law provides specific times for an individual to enroll (or to be deemed enrolled) in SMI.

The initial enrollment period (IEP) is explained in HI 00805.015. If the individual does not enroll in the IEP, or if SMI enrollment is terminated, the individual can only enroll in a GEP (See HI 00805.025), with coverage beginning the month after the month of enrollment.

Filing occurs outside enrollment period
Unless automatic enrollment applies (see HI 00805.040), an enrollment request filed outside an applicable enrollment period is not valid and must be denied.

kgmom's post suggests she was expecting the specific enrollment periods for SMI (Part B) to be dropped and Part B enrollment could occur anytime with effective date the first of the following month.

 

[LostDollar]

So the new gep is only Jan 1- march 31 for next month coverage ?

New? I don't think the GEP has changed.

 

[LostDollar]

[EXTERNAL LINK] - Federal Register :: Request Access

Another thing to note in this article is that use of one of the 5 new special seps may cancel or ameliorate Part B LEP's. I don't fully understand what I am reading there, someone with more technical expertise than I have in this area will have to comment further.

 

[kgmom219]

I skimmed the article but didn’t immediately see where they can’t start it any month after applying.
what paragraph is that in?


There’s a link in the article and the graph literally says any month you enroll in Medicare, it will start the next month. That said, it’s around 100 more pages I don’t want to read.

Can anyone confirm that? And quote it?

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.