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CMS Announces Notice for People with Marketplace Coverage and Medicare

In June, the Centers for Medicare & Medicaid Services (CMS) announced an initiative to help people with Marketplace plans transition to Medicare after a call to action from more than 40 leading consumer advocates and health insurers—led by the Medicare Rights Center.

The health insurance Marketplaces created by the Affordable Care Act (ACA) provide coverage options to people who would otherwise be uninsured. Many people currently in the Marketplace who will soon qualify for Medicare are unfamiliar with Medicare enrollment rules and timelines. A mismanaged transition to Medicare can result in higher health care costs, gaps in coverage, and even tax penalties—making adequate notice and supports critical to promoting the health and financial security of people new to Medicare.

CMS recently released a new notice that people with Medicare and Marketplace coverage will receive. The notice informs these individuals that if they have Medicare, they are most likely no longer eligible to receive the premium tax credits to help pay for Marketplace plan premiums. The notice also provides useful information on how to ensure that you are enrolled in Medicare without penalties or gaps in coverage.

Medicare Rights applauds CMS for providing enhanced notice and education to people with Marketplace plans who are also enrolled in Medicare. In addition, Medicare Rights supports ongoing efforts by the agency to reach individuals with Marketplace coverage who are approaching Medicare and will continue to work with CMS to ensure people appropriately transition from the Marketplace to Medicare. Advance notice and adequate education is fundamental to ensuring that people with Marketplace plans are prepared to enroll in Medicare.

For more information on this notice and how CMS will target appropriate individuals, view their slide deck.

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