Biden-Harris administration bolsters Medicare with finalized policies to simplify enrollment and expand access to coverage – InsuranceNewsNet

Baltimore, Maryland, October 28 — The US Department of Health and Social Services Centers for Medicare and Medicaid Services issued the following press release on October 28, 2022:

The Medicare and Medicaid Service Centers (CMS) released a final rule that updates Medicare enrollment and eligibility rules to expand coverage for people with Medicare and advance health equity. The final rule, which implements changes made by the Consolidated Appropriations Act of 2021 (CAA), makes it easier for people to enroll in Medicare and eliminates coverage delays. Among these changes, individuals will now have Medicare coverage the month immediately following enrollment, reducing coverage delays. In addition, the rule expands access through Medicare’s Special Enrollment Periods (SEPs) and allows certain eligible beneficiaries to receive Medicare Part B coverage without a late enrollment penalty.

The Biden-Harris administration made expanding access to health care a top priority, and under their leadership, more Americans than ever before have health insurance coverage. Today’s final rule builds on that success and supports the administration’s additional efforts to strengthen Medicare.

The Biden-Harris administration made it clear: We are committed to doing everything we can to strengthen Medicare,” the HHS secretary said. Xavier Becerra. “Today, we’re making it easier to enroll, expanding access, and eliminating coverage delays to improve Medicare for the millions of Americans who depend on it. We work tirelessly to deliver health insurance and peace of mind. that registrants deserve.”

“CMS is committed to ensuring that those eligible for Medicare have timely access to this vital coverage,” the CMS administrator said. Chiquita Brooks-LaSure. “For the first time, special enrollment periods will be available in traditional health insurance for people who were unable to enroll due to exceptional conditions, and people who have had kidney transplants will be able to now enjoy expanded Medicare coverage for immunosuppressive drugs.Each part of this essential rule advances CMS’s strategic vision to expand access to affordable, quality health care and coverage. . »

A Special Enrollment Period (SEP) allows individuals to make changes to their health coverage outside of a typical enrollment period. SEPs finalized in this rule provide the opportunity for eligible individuals to enroll in Part B if they did not enroll in Medicare during their initial enrollment period when they were first eligible, and to do so no late registration penalty. Examples of new SEPs created by this rule are SEPs for eligible individuals who miss an enrollment opportunity because: 1) they have been affected by a government-declared disaster or emergency; 2) their employer or health insurance plan has significantly misrepresented timely Medicare Part B enrollment information; 3) they were incarcerated; and 4) their Medicaid coverage was terminated after the end of the COVID-19 PHE or on or after January 1, 2023 (whichever comes first).

The final rule also establishes a new immunosuppressive drug benefit that extends lifesaving Medicare immunosuppressive drug coverage to certain people who have had kidney transplants and who would otherwise lose Medicare coverage. Changes finalized in this rule come into effect on January 1, 2023.

These changes not only implement important provisions of the Consolidated Appropriations Act of 2021 (CAA), but also support of President Biden Federal Customer Experience and Service Delivery Transformation Executive Orders for Rebuild trust in government and continues to strengthen Americans’ access to affordable, quality health care coverage by eliminating confusing wait times and allowing CMS and the Social Security Administration to address missed enrollment periods by allowing eligible individuals to enroll in Medicare Part B through SEPs for exceptional terms. Additionally, these changes support the Administration’s vision for CMS: to serve the public as a trusted partner and steward, dedicated to advancing health equity, expanding access to coverage and affordable care and improved health outcomes.

“These changes underscore CMS’s efforts to advance health equity and improve access to Medicare,” said Dr. Meena Seshamanideputy administrator of the CMS and director of the health insurance center. “Reducing coverage gaps, allowing special enrollment periods for people in exceptional circumstances, spending money smarter on kidney transplant patients – these are meaningful changes that put people at the center of their care and improve the Medicare program.”

Finally, CMS is making several technical updates to improve the administration of Medicare savings programs. These programs help make health insurance affordable for those struggling to pay for health care.

CMS encourages people approaching Medicare eligibility to research their Medicare coverage options and enrollment deadlines. Both and 1-800-MEDICARE are available to help people understand their choices and associated timelines. In addition, personalized health insurance counseling is available free of charge from State Health Insurance Assistance Programs (SHIPs). Visit or call 1-800-MEDICARE for the phone number for each SHIP.

Medicare Open Enrollment works from October 15 to December 7, 2022. Meanwhile, those eligible for Medicare can compare 2023 coverage options on provides clear, easy-to-use information and an updated health insurance plan search tool to help people compare health and drug coverage options, which may change from year to year. in year.

Medicare Plan Finder has been updated with the 2023 Medicare Health and Prescription Drug Plan information at October 1, 2022. 1-800-MEDICARE is also available 24 hours a day, seven days a week to provide help in English and Spanish as well as language support in more than 200 languages. People who want to keep their current Medicare coverage do not need to re-enroll.

During open enrollment, people with Medicare who take insulin are encouraged to call 1-800-MEDICARE or contact their state health insurance assistance programs (https://www. for help comparing plans and costs this year.

To view a fact sheet on the final rule, visit: medicare-2

To view the final rule, visit:

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