How Medicare Access Will Change in 2023: A Medicare Customer Question

Prospective beneficiaries looking to sign up for Medicare will be seeing improved coverage access in the New Year.

On Oct. 28, the Centers for Medicare and Medicaid Services announced that it has finalized policies to reduce gaps and eliminate delays in Medicare coverage, which will go in to effect on Jan. 1, 2023.

Thanks to CMS implementing changes required by the Consolidated Appropriations Act of 2021, first-time Medicare enrollees will now have Medicare Part B coverage the month immediately after enrollment, and those who enroll during the general enrollment period (GEP) can opt into Medicare Part B coverage without a late enrollment penalty.

The changes will also expand special enrollment periods (SEPs), to allow beneficiaries to sign up for Medicare Part B without a late penalty in certain circumstances.

The Question:

What changes can prospective beneficiaries expect to see with Medicare access in 2023?

The Answer:

In the past, when a senior signed up for Medicare Part B during the last few months of their initial enrollment period (IEP), benefits did not begin right away.

Beneficiaries would have to wait an additional two or three months before their coverage kicked in.

Fortunately, the new CMS implementations will make benefit coverage immediately available upon enrollment.

Effective in 2023, if your client enrolls in Medicare during the last three months of their IEP, their coverage will start on the first day of the month after initial signup without delay.

Beneficiaries who miss their IEP will also have expanded access to Medicare.

They can still sign up for both Medicare Part A and Part B during the general enrollment period (GEP), which runs every year from Jan. 1 to March 31.

Historically, Medicare benefits would not begin until July 1 following the GEP; however, this waiting period will also be lifted, beginning in January 2023.

Medicare coverage will begin the first day of the month after signup.

New SEPs will also expand Medicare Part B signup throughout the year without a late penalty, depending on the beneficiary's circumstances.

New beneficiaries who have faced exceptional conditions will not incur a late-enrollment fee if they missed their IEP due to a disaster or government-related emergency, incarceration, loss of Medicaid eligibility after Jan. 1, 2023, or employer or health plan errors in Medicare enrollment information.

These amendments to Medicare access come on the heels of the Social Security Administration announcing an 8.7% increase in Social Security and Social Security Disability Insurance (SSDI) benefits in 2023.

These Medicare improvements underscore the need for older workers to examine their health insurance options and compare their employer health plan coverage to Medicare.

Waiting-period modifications and expanded Medicare access give older workers and prospective beneficiaries more flexibility as they look for ways to reduce their health care costs to best meet their health care need.

Bethany Cissell is a health care insurance services specialist at Allsup.