While most people are automatically enrolled in Medicare Part B—because they are collecting Social Security retirement benefits at age 65—a growing number are not, as they are working later in life and deferring their Social Security benefits. Unlike those who are auto-enrolled, these individuals must make an active Medicare enrollment choice, taking into consideration specific timelines and existing coverage. If this transition is mismanaged, individuals new to Medicare may face lifetime late enrollment penalties, higher health care costs, gaps in coverage, and disruptions in care continuity.
Unfortunately, many individuals do make mistakes—often because they are not informed about their enrollment responsibilities or Medicare’s complex enrollment rules. These rules are so complicated that even the most sophisticated Human Resources experts struggle to follow them, and many employers’ benefits departments lack the Medicare knowledge to guide their employees and retirees on Medicare enrollment. Clear and simple advice to those approaching eligibility could help prevent enrollment errors, but today the federal government provides virtually no notification to people nearing Medicare eligibility that they may need to actively enroll or how and when to do so. As a result, people with employer-based or other private coverage often bear the full burden of navigating Medicare’s complicated enrollment system.
The bipartisan Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act
(S. 1280/H.R. 2477), championed by Senators Todd Young (R-IN) and Bob Casey (D-PA) and Representatives Raul Ruiz (D-CA), Gus Bilirakis (R-FL), Brad Schneider (D-IL), and Jackie Walorski (R-IN) includes commonsense solutions to address these challenges.
Any changes to the Medicare program must aim for healthier people, better care, and smarter spending—not paying more for less. As policymakers debate the future of health care, we will provide our insights here.
Thinking ahead to Medicare's future, it’s important to modernize benefits and pursue changes that improve how people with Medicare navigate their coverage on a daily basis. Here are our evolving 30 policy goals for Medicare’s future.
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