The Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) recently expanded the functionality of the Medicare enrollment
process to accommodate more online applications during the coronavirus pandemic. Previously, only people applying for Medicare Parts A and B at the same time
could use the online portal. People who were already enrolled in Part A and were using a Special Enrollment Period (SEP) or seeking Equitable Relief to enroll in
Part B had to submit documentation to SSA in person or via fax—an option made available during the current public health emergency.
Under the modernized system, people who are eligible for a Part B SEP can now apply online. To qualify for this enrollment window, either they, their spouse, or
sometimes a family member, must currently have or have recently lost a job that provided health insurance. Applicants must also upload proof of this job-based
coverage, to show they have been consistently insured since becoming Medicare-eligible. Typically, people submit this documentation with Form CMS-L564, which
their employer must fill out and sign. However, if people are unable to obtain their employer’s signature, as many are during the pandemic, they can supply
other proof instead, including:
- Income tax returns that show health insurance premiums paid
- W-2s reflecting pre-tax medical contributions
- Health insurance cards with dates
- Explanation of benefit documents showing claims processed or paid by the job-based insurance
- Statements or receipts that show health insurance premium payments
While this portal is a welcome update, additional Medicare enrollment improvements are still needed. Even with these changes in place, not all Medicare
applications can be completed online, and not everyone has access to a computer or the ability to upload the required documents. It is critical that SSA offices
have the capacity to assist with and process all enrollments, and that applicants have the information they need to make timely coverage decisions. During the
public health emergency in particular, additional enrollment protections remain necessary.
YOu can find the full blog post at Medicare Rights Center.