H.R. 2744: Medicare Enrollment Protection Act of 2025

This bill, known as the Medicare Enrollment Protection Act of 2025, aims to amend certain provisions of Medicare concerning individuals who are enrolled in COBRA continuation coverage. Here are the key components of the bill:

Special Enrollment Period

The bill establishes a special enrollment period for individuals who are currently enrolled in COBRA continuation coverage or who had been enrolled prior to their COBRA coverage. The conditions include:

• If an individual meets specific criteria while enrolled in COBRA coverage, they can enroll in Medicare.
• This special enrollment period includes every month during which they are enrolled in COBRA as well as a three-month period that starts the month after their COBRA coverage ends.
• Individuals can only utilize this special enrollment period once in their lifetime.

Coverage Period for Eligible Individuals

The bill modifies how the coverage period begins for those who enroll under the special enrollment provisions. It specifies that coverage will start on the first day of the month following their enrollment in Medicare.

No Increase in Premiums

The bill states that individuals who enroll in Medicare during this special enrollment period will not face increased premiums due to their prior enrollment in COBRA. This is aimed at ensuring that their COBRA coverage does not count against them when calculating premiums for Medicare coverage.

Coordination of Benefits

The bill includes provisions regarding the coordination of benefits between COBRA and Medicare:

• Individuals enrolled in COBRA coverage who are also eligible for Medicare will not have their COBRA benefits reduced or terminated simply because they are eligible for Medicare.
• Healthcare benefits under COBRA must be maintained at the same level for individuals despite their eligibility for Medicare. However, this does not guarantee the provision of COBRA coverage for individuals who choose to enroll in Medicare.

Updating Notifications

Lastly, the bill mandates that by January 1, 2026, the Secretary of Labor, in coordination with the Secretary of Health and Human Services, must update notification requirements related to COBRA coverage. These updated notifications must explain the implications of Medicare secondary payer rules and how they affect individuals under COBRA coverage.

Relevant Companies

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