The Centers for Medicare & Medicaid Services Friday finalized a rule updating Medicare enrollment and eligibility rules to strengthen coverage and ease enrollment, as required by the Consolidated Appropriations Act of 2021. AHA expressed support for the updates in an April letter to the agency. 

Effective immediately under the rule, individuals with end stage renal disease who do not have other health insurance can enroll in Medicare Part B coverage for immunosuppressive drugs beyond the 36-month post-transplant period. 

Effective Jan. 1, coverage for individuals enrolling in traditional Medicare during the last three months of their initial enrollment period or during the general enrollment period will begin one month after enrollment. The rule also creates special enrollment periods for people impacted by an emergency or disaster; who were formerly incarcerated or had their Medicaid eligibility terminated; or whose employer or health plan materially misrepresented information related to timely enrolling, among other exceptional conditions.

In addition, the rule requires states to specify their policy for paying Medicare Part A and B premiums on behalf of low-income individuals in their Medicaid plan; and limits states’ liability for retroactive Part B premiums to 36 months for certain full-benefit dually eligible beneficiaries, among other changes.

Related News Articles

Headline
The AHA has released a social media toolkit with sample posts and graphics encouraging people to sign up for 2026 health coverage via the Health Insurance…
Headline
A new report from KFF reveals that Medicare Advantage enrollees had access to just 48% of the physicians available to Traditional Medicare beneficiaries in…
Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
Annual premiums for employer-sponsored family health coverage in 2025 increased 6% over last year to $26,993, according to KFF’s annual Employer Health…
Headline
The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and…
Headline
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans…