SCHUMER REVEALS: THOUSANDS OF UPSTATE NEW YORKERS COULD BE LEFT UNINSURED OR FORCED TO PAY MASSIVE, LIFETIME FEES & PENALTIES IF THEY DO NOT REGISTER IN TIME FOR MEDICARE; SCHUMER BILL WOULD REQUIRE FEDS TO NOTIFY SENIORS BEFORE ANY NEW YORKER IS GUT-PUNCHED WITH PENALTIES
Medicare Enrollment Is Complex And Those Not Receiving Social Security At 65 Are Required To Enroll Themselves; Schumer Bill Would Require Feds To Notify Individuals Turning 65 To Enroll Before They Are Forced To Pay Lifetime Penalties And Fees
Enrollment Errors Have Affected Thousands Of Upstate New Yorkers; If Enrollment Missed, Individuals Must Often Wait A Full Year to Receive Insurance; Clear And Simple Advice To Those Approaching Eligibility Age Could Help Address The Problem
Schumer: A Simple Notice Could Prevent Seniors From Paying An Arm And A Leg In Fees
U.S. Senator Charles E. Schumer today pushed new legislation that would require the federal government to send notification to seniors of their Medicare eligibility six months before being eligible to enroll. Right now, individuals who forget or do not apply for Medicare within their initial enrollment period are forced to pay exorbitant lifetime fees and penalties. Additionally, eligible beneficiaries who fail to enroll during their initial enrollment period may have to wait up to a full year before they can enroll in Medicare and are hit with a 10 percent penalty on their Medicare Part B Premium for every year they were not enrolled. This 10 percent or greater penalty is added to the premium for the duration of their Medicare coverage. Schumer said this is unacceptable and a clear and simple notification to those approaching eligibility could help address the problem.
“It may sound simple, but this notice is so much more than a reminder – it’s a lifeline,” said Senator Schumer. “Millions of seniors in New York rely on their Medicare benefits to lead comfortable, independent and healthy lives. But unfortunately, Medicare’s current rules are so convoluted that many seniors are at risk of facing critical gaps in coverage when they could desperately need these benefits, or face exorbitant, lifetime penalties that could negatively impact their quality of life. I’m calling on my colleagues to pass this urgently needed, commonsense legislation because a clear and simple notification for those nearing eligibility would go a long way toward addressing this problem and preventing our seniors from being hit with unending, costly fees.”
Schumer explained that when seniors start taking Social Security benefits, they are automatically enrolled in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) if they signed up for Medicare Part B at the time they signed up for Social Security benefits. However, an increasing number of Americans are working longer and are therefore deferring their Social Security benefits past the age of 65. As a result, those who would be new to Medicare are required to proactively enroll in the program in order to receive their health benefits. But oftentimes, Schumer explained, these soon-to-be eligible seniors fail to properly enroll because they are not informed of Medicare’s complex enrollment process and rules.
Schumer said that when this happens, and individuals do not apply for Medicare as soon as they become eligible, those who should be receiving these benefits are affected in three main ways. First, under current law, if a newly eligible senior misses their enrollment deadline, they are typically forced to wait until the next general enrollment period to enroll (January 1 through March 31), which could be the following year. Then, once they enroll, their Medicare benefits will not go into effect until the next July. Schumer said this could leave people dangerously uninsured for a long period of time. Second, because these eligible beneficiaries did not originally enroll in Medicare when they were first eligible, they are hit with a penalty as high as 10 percent on their Medicare Part B Premium for every year they were not enrolled. This penalty is added to the premium for the duration of their Medicare coverage, meaning they face a lifetime fee that they cannot escape. According to the Medicare Rights Center, in 2014, about 1.4 percent of Part B enrollees (roughly 750,000 nationwide) paid this penalty. On average, their total premiums (standard premium plus penalty) were about 29 percent higher than what they would have been had they not been subject to the penalty. Finally, according to the Medicare Rights Center, many older adults paying for private coverage learn only after a medical treatment that their insurance is secondary to Medicare, and that relying on their insurance instead of enrolling in Part B can create a “gap” in coverage that can cost hundreds of thousands of dollars out-of-pocket.
According to the Medicare Rights Center, the federal government currently does not provide any warning to people nearing the age of 65 that must actively enroll in Medicare, but a clear and simple notification for those approaching Medicare eligibility could help address these problems. Schumer is therefore urging his colleagues in Congress to support soon-to-be legislation that would help prevent seniors from losing out on coverage and having to pay exorbitant lifetime penalties. Schumer explained that this legislation would include three main provisions aimed at changing this process to serve Medicare recipients across New York and the country:
First, this legislation would require the federal government to send out a warning or notification to seniors as they approach 65 that they need to sign up for Medicare.
- Specifically, the Department of Health and Human Services (HHS) would be required to work with the Social Security Administration (SSA), the Department of Labor (DOL), and the Treasury Department to develop a notice for those approaching eligibility of when and how they should enroll. Schumer said many federal agencies are looking to help improve the system, but a directive from Congress is needed to facilitate a comprehensive interagency solution.
Second, this bill would help eliminate coverage gaps for seniors.
- Schumer explained that this bill would establish that Part B insurance coverage will begin the month immediately following enrollment. Right now, coverage does not start until the next July after general enrollment. This measure would ensure that beneficiaries do not experience a break in critical coverage.
Third, the bill would clarify the appeals process for those looking to pursue recourse for their penalty.
- Schumer said that, right now, those who make an honest mistake must face an opaque appeals process that requires them to prove they received erroneous advice from a federal official. Current law provides no process for those seeking equitable relief for failing to enroll in Medicare. Schumer said this standard is virtually impossible to meet and, therefore, the system has to be changed.
“With 10,000 Baby Boomers aging into Medicare every day, many of them New Yorkers, our phones are ringing off the hook with callers confused about how and when to enroll in Medicare,” said Joe Baker, President of the Medicare Rights Center. “A notice to people who are nearing Medicare eligibility is a simple solution to prevent honest enrollment mistakes, which saddle too many with higher costs and leave others without care. We applaud Senator Schumer for advancing legislation to fix this problem for New Yorkers and for older adults, people with disabilities, and families nationwide.”
During the call, Schumer highlighted the number of seniors in Upstate New York that will become eligible for Medicare and therefore need to enroll over the next five plus years. According to NY State Census data, in Upstate New York alone, there were 464,749 seniors age 60-64 eligible for Medicare in 2010. According to Cornell University’s Program on Applied Demographics, there were an estimated 527,288 seniors age 60-64 eligible to receive Medicare benefits in 2015, and there are 563,943 seniors age 60-64 estimated to be eligible for Medicare by 2020. Schumer said these increasing numbers show that this process must be fixed before more people, who are soon to be eligible for Medicare, are hit with exorbitant fees and are forced to endure gaps in coverage in the years to come:
- In the Capital Region, approximately 66,783 seniors became eligible to receive Medicare benefits between 2010-2015; an estimated 76,665 are or will become eligible between 2015-2020 and an estimated 81,017 will become eligible between 2020-2025 and need to enroll.
- In Central New York, approximately 56,521 seniors became eligible to receive Medicare benefits between 2010-2015; an estimated 65,918 are or will become eligible between 2015-2020 and an estimated 70,033 will become eligible between 2020-2025 and need to enroll.
- In Western New York, approximately 75,345 seniors 64 became eligible to receive Medicare benefits between 2010-2015; an estimated 87,314 are or will become eligible between 2015-2020 and an estimated 92,803 will become eligible between 2020-2025 and need to enroll.
- In the Rochester-Finger Lakes, approximately 67,637 seniors became eligible to receive Medicare benefits between 2010-2015; an estimated 76,261 are or will become eligible between 2015-2020 and an estimated 80,776 will become eligible between 2020-2025 and need to enroll.
- In the Southern Tier, approximately 44,094 seniors became eligible to receive Medicare benefits between 2010-2015; an estimated 50,075 are or will become eligible between 2015-2020 and an estimated 52,109 will become eligible between 2020-2025 and need to enroll.
- In the Hudson Valley, approximately 123,907 seniors became eligible to receive Medicare benefits between 2010-2015; an estimated 136,830 are or will become eligible between 2015-2020 and an estimated 150,206 will become eligible between 2020-2025 and need to enroll.
- In the North Country, approximately 30,462 seniors became eligible to receive Medicare benefits between 2010-2015; an estimated 34,225 are or will become eligible between 2015-2020 and an estimated 36,999 will become eligible between 2020-2025 and need to enroll.
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