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The Centers for Medicare & Medicaid Services (CMS) has issued proposed changes to Medicare that will make it easier to get coverage, simplify enrollment, expand access, and implement improvements to the administration of Medicare Savings Programs. Below is an overview of what’s coming in 2023.

Earlier Enrollment for Medicare 

Currently, if people enroll in Medicare in the General Enrollment Period or the final three months belonging to their Initial Enrollment Period, they will probably have to wait several months for their coverage to start.

The proposed change would mean that Medicare coverage would begin the month immediately following enrollment, thereby shrinking any potential coverage gaps. This is especially important for people with certain conditions such as cancer, as enrollment restrictions or waiting periods cause disruptions in care and delays in screening and treatment.

SEPs Will Be More Widely Available

Medicare access will be broadened through Medicare special enrollment periods (SEPs) which will become available for individuals who were previously unable to enroll because of exceptional conditions. Eligible beneficiaries would also be allowed to receive Medicare Part B coverage without being subjected to a late enrollment penalty.

Individuals who are covered under Part D and Medicare Advantage can also use SEPs to make changes to their Medicare coverage should certain events occur in their lives, such as losing other insurance coverage or moving. Rules about when Medicare recipients are allowed to make changes to their coverage and the type of changes they can make differ for each SEP.

Coverage for Immunosuppressive Drugs

Vital coverage for life-saving immunosuppressive drugs will be provided for people who otherwise would be losing all Medicare coverage. This program would be beneficial to certain individuals who have had a kidney transplant.

Improved Administration

CMS is proposing several technical updates aimed at improving the administration of Medicare Savings Programs, which help make Medicare affordable for people struggling to afford health care.

What You Should Do

If you are drawing near to Medicare eligibility or are caring for someone who is, you should research coverage options and take note of enrollment deadlines. 1‑800-MEDICARE and Medicare.gov can help you understand your choices and associated deadlines. Also, free personalized health insurance counseling is available from State Health Insurance Assistance Programs (SHIPs). Click on shiptacenter.org or call 1-800-MEDICARE to obtain each SHIP’s phone number.

You can find the proposed rule by visiting this link. In addition, a fact sheet on the proposed rule is accessible by clicking here.

Changes to Medicare – To Sum Up

If finalized, these changes would take effect on January 1, 2023. The proposed rule encompasses the following changes to Medicare:

  • It would be easier for people to enroll.
  • It would eliminate delays and gaps in coverage.
  • It would do away with late enrollment penalties for individuals meeting exceptional conditions.
  • It would provide life-saving benefits to kidney transplant patients.

Caring Healthcare in Columbia, SC

Medicare rules and regulations are often difficult to understand, but the new rules will help to give people the peace of mind that comes with having coverage when they need it. Peace of mind can also come from knowing that an experienced and highly-trained home healthcare professional is there to help care for your loved one as they approach eligibility for Medicare. Please get in touch with us for more information.