Oct 31, 2022 - Health

Medicare expands special enrollment periods

Illustration: Aïda Amer/Axios

People who miss Medicare's open enrollment next year because of extenuating circumstances will get a special sign-up period to ensure continuous coverage under a rule finalized Friday.

Why it matters: The Centers for Medicare & Medicaid Services (CMS) rule aims to keep people who fall off Medicaid rolls and other groups from falling into a coverage gap. It could also help those who were incarcerated, got caught up in an emergency or were victimized by a private health plan's administrative error.

  • CMS previously didn't make such exceptions. Congress required the changes, and the agency proposed them in April.
  • "These policies would help reduce disparities in care and promote health equity by eliminating barriers to and ensuring ease of enrollment in Medicare, thereby expanding healthcare coverage," the American College of Emergency Physicians wrote in a May letter to CMS.

Details: Seniors can generally opt into their Medicare Part B coverage in the three months before and after their 65th birthday, or in the eight months after their group or employer health coverage ends. If they miss the window, a late fee will be added to their premium for the rest of their enrollment.

  • Beginning Jan. 1, people who miss those windows due to extenuating circumstances can get Part B coverage without a penalty.
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