Many individuals are enrolled in Medicaid when their Initial Enrollment Period (IEP)
for premium Part A or Part B begins. While some individuals stay eligible for Medicaid
after they qualify for Medicare, other individuals lose Medicaid eligibility entirely.
Individuals transitioning from Medicaid to Medicare coverage are at risk for gaps
in coverage and losing access to critical health care. Administrative delays may keep
individuals in Medicaid for multiple months after they first qualify for Medicare
and become ineligible for Medicaid benefits.
Individuals who retain Medicaid after qualifying for Medicare may miss their IEP because
they continue to be covered by Medicaid and may think they do not need or cannot afford
Medicare at that time.
If they lose Medicaid coverage outside of the Medicare General Enrollment Period (GEP),
they may need to wait months to enroll in Medicare and be subject to a premium surcharge
when they can eventually enroll.
This SEP would help promote continuity of coverage for individuals who lose Medicaid
eligibility and did not enroll in Medicare on time.