Needed Changes to the Medicare Enrollment Process 2022
I have been a licensed insurance agent since 2003. I’ve seen a lot of changes to Medicare over that time. One of the problems that always baffled me was how difficult it was to enroll in Medicare. Let me put you in the front seat of the upcoming changes to Medicare for 2022 and 2023.
More than 11,000 persons turn 65 each day and become Medicare eligible. That is a lot of people enrolling in Medicare. The problem that Congress created a number of years ago was moving the full Social Security retirement age from 65 to 66 and so many months.
People are also living longer. Retirement is being pushed off because people don’t have enough saved. Consequently, many continue to work past 66 to just survive, so they remain on their employer’s group health plans. But, when they turn 65, they need to do something about Medicare enrollment.
How to Enroll with Upcoming Changes to Medicare in 2022 & 2023?
When you start your Social Security, Social Security enrolls you automatically into Medicare Part A and Part B when you turn 65. You have the option then to decline Part B. Many do if they are still working and have adequate health insurance from their employer.
Many people are not taking Social Security at 65, so Social Security does not automatically enroll them in Medicare. That number is even smaller than a few years ago.
So, people must actually choose to enroll in Part A at 65. If they are going on Medicare entirely and delaying Social Security, they must actively choose to enroll in Part A and Part B. A lot of people call Medicare complaining because of how hard it is to enroll in Medicare. Upcoming changes to Medicare in 2022 and 2023 will make the enrollment process simpler.
Enrolling in Medicare at The Social Security Administration Office
Enrolling in Medicare is a challenge, to put it kindly. I do this for a living. I like to think I have above-average intelligence and some good computer skills. However, I still find the Medicare enrollment process unnecessarily difficult and complicated.
Before the pandemic, you could go to your local Social Security office to enroll in Medicare. Depending on the office’s busyness and the staff’s competency, it was more or less complicated and very time-consuming. The primary issue was the time involved—driving to the office, waiting in line, being at the office during regular business hours when you are still working. Those were the usual challenges. As of the writing of this, the local Social Security offices are closed to visitors because of COVID. The only option now is to enroll online.
The other option for enrollment, which has become pretty much the only option now, is enrolling online. Enrolling online is not easy, even if everything goes smoothly.
In the past two years, the online process has evolved. A few months ago you took a photo of your state driver’s license. Social Security scanned your license into their system through your smartphone. The purpose was to identify you if you did not already have an active MySocialSecurity account. It was not a bad improvement over the old way, which was answering credit questions. That was an amazing bureaucratic mess in itself. I’m glad the credit questions are gone, but the technology for taking the photo of the driver’s license was faulty.
The latest method is a combination of email and text confirmation codes. This method works if there are no issues with your personal information.
The major challenge with this newest method is some of my clients do not have email or do not get emails and texts on their phones.
Challenges, however, go beyond just the mechanics of getting enrolled with Medicare. The problems are with when you can enroll, penalties when you don’t follow the rules, confusion about the rules and penalties. Frustration has built over time as more and more baby boomers run into the wall called Medicare enrollment.
Someone must have heard that consumers were not happy because Congress made some significant changes to the Medicare enrollment process for 2022 and 2023.
What Are the Upcoming Changes to Medicare for 2022?
In December 2020, Congress passed the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act of 2020. Parts of this legislation will be effective beginning in January 2023.
The changes are in five areas:
- GEP (General Election Period)
- Part B Enrollment Exceptions
- IEP (Initial Enrollment Period)
- Advanced education for Medicare enrollment
- Expanded Kidney transplant patient coverage
What Are Medicare General Enrollment Period Changes For 2022 & 2023?
Sometimes people miss their Initial Enrollment Period (IEP), which occurs when they turn 65. If you do not have health insurance from 65 onward, you cannot enroll in Medicare until the General Election Period (GEP), January 1st—March 31st. The delay is part of the punishment for missing your IEP. You may also incur the 10% permanent late enrollment penalty.
The problem with the rules around GEP is that Medicare Part A and/or Part B does not start until July 1st after you enrolled sometime from January 1st–March 31st. Consequently, a person cannot get a Medicare Supplement or Part D plan until then. Medicare Part C/Medicare Advantage plans are delayed even further until Annual Election Period (AEP) in October. You are without comprehensive health coverage for many months after an already delayed enrollment.
The BENES Act changes GEP (General Election Period). Congress moved GEP from the first three months of the year to the last three months of the year—October 15th—December 31st—to coincide with the Medicare Annual Election Period (AEP), which is October 15th–December 7th. The hope was to reduce confusion and enable a newly enrolled beneficiary to get maximum coverage right away. For example, if you enrolled in November during the GEP, your Medicare would start on Dec 1st.
Medicare Changes in 2022 Allow For More Exceptions
Medicare enrollment periods are very restrictive and precise. The handbook that agents must learn runs to many pages for Medicare election periods when someone can enroll in Medicare or make changes to a Medicare plan. Often I cannot enroll someone in a plan or change their plan, even when the situation is terrible, because of the restrictive enrollment election criteria.
The new law allows the Secretary of Health and Human Service to initiate a particular enrollment period for Part B when exceptional circumstances arise. Of course, we all can think of the pandemic as the perfect example.
The Last 3 Months of Initial Enrollment Period
Many people know that your Initial Enrollment Period (IEP) is three months before the month of your birthday, the month of your birthday, and the three months afterward. What people do not realize about this rule is there are additional rules for the last three months. This provision has been the bane of my existence—as well as a few clients—for years.
Staggered Medicare Start Dates Change in 2023
Sometimes people will delay enrolling in Medicare when they turn 65 to coincide with a spouse turning 65, a retirement date, the end of a school year, etc. The problem with enrolling after you turn 65 is the start dates are staggered.
For example, you are turning 65 in July, but your spouse is turning 65 in October and needs you to remain on the employer health plan so she can have health insurance. You want to enroll in Medicare for an October 1st start date so it coincides with your spouse, but you can’t.
If you enroll in August, your Medicare will start in September. If you enroll in September, your Medicare will start two months in November under the current rules. You will need to enroll in Medicare in August, so your Medicare starts in September. Your spouse will enroll during the three months before, so it starts on October 1st. You will need to double pay for insurance for one month because of the unusual Medicare rules.
The upcoming changes to Medicare in 2022 and 2023 do away with the silliness. Joe can enroll in September for October and not have to pay double for health insurance. I can’t tell you how many times this has been an unnecessary burden for my clients going on Medicare.
This change will allow people retiring at the end of their IEP (Initial Enrollment Period) to have a smoother transition from employer coverage to Medicare without a lapse in coverage or double paying.
Medicare Part B after 65
I find that Medicare does not explain very well how Medicare works when you work past 65 or beyond and have an employer health plan. I hear the standard response from Medicare and Social Security bureaucrats. They encourage people to enroll only in Part A and stay on their employer’s health plan as long as they are working.
In the past, that standard answer may have worked, but when more and more people are working past 65 and full Social Security retirement is 66+, reality changed.
Also, employer plans have steadily declined in quality during the past fifteen years. Health plan costs have increased and coverage has decreased significantly. I find the vast majority of employer health plans are inferior to Medicare Advantage or Original Medicare and a supplement.
Medicare Enrollment Deadline & Penalty
The most common issue around Medicare is initial enrollment, which is when people turn 65. Some people claim they didn’t know about their Medicare enrollment. I’m not sure how that is possible because most people’s mailbox is jammed full of mail announcing they are turning 65 and need to get signed up for Medicare.
The real issue around 65 is should I enroll in Medicare, and how do I quickly do that? I find a lot of legitimacy around that question.
The upcoming changes to Medicare in 2022 & 2023 through the BENES Act will include notifying people of Medicare eligibility. The notifications will start at ages 60 to 64. Medicare will send information to explain rules such as Medicare eligibility, timeframes for enrollment, Medicare penalties, delaying Medicare without penalty, Part B coordination of benefits, and other online resources will be included on the notice. The purpose is to alert beneficiaries, so no one misses their opportunity.
If your mailbox was not full enough when you turned 65, it will be stuffed to overflowing now.
Medicare For Kidney Transplant Patients
End-Stage Renal Disease (ESRD) is one of the ways you qualify for Medicare before age 65.
If you are under 65 and diagnosed with ESRD, you can enroll in Medicare for a specific number of months. For example, now if you qualify for Medicare based on ESRD and have a kidney transplant, your Medicare coverage will end 36 months after the month of your transplant.
The BENES Act of 2020 change will allow kidney transplant beneficiaries to continue their Medicare Part B coverage past 36 months if they have no other health insurance source. The purpose of this is so these beneficiaries will continue to have coverage for immunosuppressive drugs.
According to the Social Security Administration (SSA), Part B’s premium under these circumstances would be less than the base premium and not subject to late penalties.
When Does the BENES Act Take Effect?
The BENES Act will take effect on January 1, 2023, but like many laws, different aspects will be implemented over time to give all the institutions and organizations time to comply.
The two changes I think most important are General Election Period (GEP) and Initial Enrollment Period (IEP). Those will be implemented on the start date–January 1, 2023. The outreach program and kidney transplant patients will take about two years to enact the changes fully.
The number of people enrolling in Medicare is monster. I think all the Baby Boomers enrolling in Medicare have forced politicians and bureaucrats to streamline the Medicare system. Upcoming changes to Medicare enrollment in 2022 and 2023 are going to make life easier. Late enrollment penalties and complaints should decline significantly with the more efficient and user-friendly rules. The most vulnerable, like kidney transplant patients, will have better options.
Medicare and Medicare insurance, however, is still complicated. When you need help understanding the new BENES rules and all the others, give us a call at 402-614-3389 and speak with a licensed and experienced insurance professional.