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The Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act

Summary: In 2020, lawmakers and organizations came together to create the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act which went into effect on January 1, 2023. Now, Medicare is more widely available, ending a seven-month waiting period and improving communications. Estimated Read Time: 3 mins

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Table of Contents:

  1. What is the BENES Act?
  2. What Are the Primary Components of the BENES Act?
  3. Who Supports the BENES Act?
  4. How To Transition Into Medicare Sooner With the BENES Act

The Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act is a bipartisan bill that was signed into law in 2020 with its contents going into effect in 2023.

In 2020, the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act passed the House and Senate before being signed into law. It was a voice vote, therefore, there are no records of individual votes, but the bill is now in effect. Below, we explain what the BENES Act is, how it is still relevant in 2024, and what its changes mean for your Medicare coverage.

What is the BENES Act?

The BENES Act makes the process of enrolling in Medicare easier and more accessible for eligible enrollees to understand. Additionally, the law extends the timeframe of Medicare coverage for some eligible individuals due to End-Stage Renal Disease (ESRD).

Beneficiaries signing up for Medicare for the first time during the General Enrollment Period will now receive coverage the first day of the following month. Previously, beneficiaries enrolling during this time would need to wait until July 1 for their coverage to go into effect.

Additionally, beneficiaries who sign up during their Initial Enrollment Period but in one of the months following their 65th birthday will have their Medicare become effective on the first day of the month after they sign up.

The act also provides a Special Enrollment Period for Medicare Part B during extraordinary circumstances, such as following a hurricane.

Another component of the bill provides outreach from the Centers for Medicare & Medicaid Services (CMS) in collaboration with the Social Security Administration (SSA) to inform and educate soon-to-be eligible individuals about enrollment and extends Medicare coverage for ESRD patients under the age of 65 if they otherwise lack health insurance.

The U.S. Department of Health and Human Services (HHS) was also tasked with not only aligning Medicare Annual Enrollment Periods for Medicare Advantage plans and Medicare Part D prescription drug plans with the annual General Enrollment Period, but also collecting data and providing Congress with what it found.

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What Are the Primary Components of the BENES Act?

Now that the BENES Act is now in effect, it’s important to note the important updates to Medicare. Below, are some of the primary components of how it works, including:

  • Eliminating the seven-month waiting period beneficiaries can encounter after enrolling during the General Enrollment Period.
  • Adds a provision for a Special Enrollment Period in Medicare Advantage and Medicare Part D due to exceptional circumstances, allowing for more flexibility and increased access to care.
  • The alignment of Medicare enrollment periods to reduce confusion.
  • Those who will become eligible for Medicare will receive a notice in the mail two or more times within the three months leading up to their enrollment period when turning 65 years of age.

Who Supports the BENES Act?

The act was introduced by eight former Medicare program administrators. It has support from politicians on both sides of the aisle. Here’s a breakdown of the political support:

  • Senators Bob Casey (D-PA), Todd Young (R-IN), Susan Collins (R-ME), Debbie Stabenow (D-MI), Rob Portman (R-OH), and Christopher Coons (D-DE)
  • Representatives Raul Ruiz (D-CA), Jackie Walorski (R-IN), Brad Schneider (D-IL), and Gus Bilirakis (R-FL)

Additionally, support comes from over 85 national and state organizations representing older Americans and people with disabilities, such as various insurance carriers and the Medicare Rights Center.

How To Transition Into Medicare Sooner With the BENES Act

Medicare involves many components and can seem opaque at times. Consequently, many people who age into Medicare find the program confusing. Thus, the purpose of the BENES Act is to simplify certain aspects of Medicare so beneficiaries can transition to their new healthcare with increased ease. Additionally, it will help more Americans with failing kidneys obtain affordable healthcare.

Often, when individuals reach Medicare age and don’t have a proper understanding of its rules, they encounter financial penalties due to gaps in coverage. Now that the BENES Act is in effect, beneficiaries receive advance notice for their Medicare eligibility preventing potential penalties.

Here at MedicareFAQ, our team is here to help beneficiaries like you understand their healthcare options. This includes educating beneficiaries about the best way to transition into Medicare and changing regulations.

The BENES Act may be able to help you avoid penalties. Contact us today to explore your options by calling the number above or clicking the compare rates button below to discover Medicare options in your area.

Sources

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. H.R. 2477 (116th): BENES Act of 2020, GovTrack. Accessed October 2023.
    https://www.govtrack.us/congress/bills/116/hr2477
  2. Beneficiary Enrollment Notification and Eligibility Simplification Act (BENES Act) (S. 1280/H.R. 2477), U.S. Senate Special Committee on Aging. Accessed October 2023.
    https://www.aging.senate.gov/imo/media/doc/BENES%20Act%20One%20Pager%200419.pdf
  3. Medicare Rights Welcomes Passage of Key BENES Act Provisions, Medicare Rights Center. Accessed October 2023.
    https://www.medicarerights.org/media-center/medicare-rights-welcomes-passage-of-key-benes-act-provisions
Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare educator serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

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