In this article we review current Medicare enrollment tips and considerations.
End of active employment triggers a Special Enrollment Period for Medicare
Due to the current pandemic, many older workers may have lost jobs or decided to retire and now find they need Medicare coverage. We generally counsel readers and clients to enroll in Medicare when they first become eligible. If someone chooses not to enroll in Medicare when they are first eligible because they are still working and covered by employer-provided insurance, they must act quickly once they stop working; the clock starts ticking on the Special Enrollment Period (SEP) to enroll in Medicare, even if they remain on employer-provided coverage through COBRA or a retiree plan.
Individuals who delay enrolling in Medicare Part B (which covers doctor and other health care providers' services and outpatient care) because they were working and had coverage through their employer have an eight-month SEP to enroll. This SEP is also available to individuals who delay enrolling in Part B because their spouse was working and the individual was covered through their spouse’s employer-provided insurance. The SEP starts when employment ends or employer-provided coverage ends, whichever comes first. In addition to the application for enrollment in Medicare Part B, in order to use the SEP and enroll without a penalty, the individual seeking coverage will need to have their former employer fill out a form confirming the person’s dates of employment and coverage. If someone is unable to get their employer to fill out the required form, the Social Security Administration (SSA) recommends applicants complete the form themselves, leave the employer’s signature blank, and attach proof of employer coverage.
SSA accepts Medicare applications by fax
Although Social Security Administration (SSA) offices are currently closed to the public during the COVID-19 pandemic, people can still apply for Medicare online in certain circumstances, or by mailing their Medicare enrollment forms to their local SSA office. SSA also now accepts applications by fax to 1-833-914-2016. Further information about how to apply for Medicare can be found on SSA’s website.
Equitable relief is available for people who were not able to enroll in Medicare timely
People who missed their opportunity to enroll in Medicare on or after March 17, 2020 are eligible for equitable relief until June 17, 2020. This includes people who were newly eligible for Medicare and still in their Initial Enrollment Period (IEP) on or after March 17th, as well as those who were within the annual General Enrollment Period (GEP) for Medicare (Jan 1-March 31) or were eligible for a Special Enrollment Period (SEP) on or after March 17, 2020 and did not submit a timely enrollment request to the Social Security Administration (SSA). Those who are eligible will be given an extension of their enrollment period until June 17, 2020 to enroll in Medicare. People who want to use the offered equitable relief simply need to submit the appropriate Medicare enrollment forms. Coverage for people enrolling through equitable relief should be effective the month it would have been effective had the application been filed at the time of the person’s IEP, GEP, or SEP. Since this will vary depending on people’s individual circumstances, people enrolling in Medicare through this equitable relief window should ask SSA when their coverage will begin. For more information, see here.
COVID-19-related Special Enrollment Period
CMS has extended an SEP typically to people impacted by a natural disaster to those who were eligible to make a Medicare coverage change but did not during the COVID-19 pandemic. To qualify for this SEP, the individual must have had a valid election period on or after March 1, 2020 and did not use it to make a coverage change during that valid election period. This could apply, for example, to people who did not make a coverage change during the Medicare Advantage Open Enrollment Period January 1st-March 31st. The SEP is available until July 1, 2020. As with the equitable relief detailed above, people seeking to use this SEP do not have to provide any proof that they were unable to make a coverage choice because of the COVID pandemic. See here for more information.
We encourage readers who have questions about enrolling in Medicare or who need help to enroll or make plan changes to call APPRISE at 1-800-783-7067.