I 

116TH CONGRESS 

1ST SESSION H. R. 2477 

To amend title XVIII of the Social Security Act to establish a system 

to notify individuals approaching Medicare eligibility, to simplify and 

modernize the eligibility enrollment process, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 2, 2019 

Mr. RUIZ (for himself, Mrs. WALORSKI, Mr. SCHNEIDER, and Mr. BILIRAKIS) 

introduced the following bill; which was referred to the Committee on 

Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in 

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to establish 

a system to notify individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment 

process, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Beneficiary Enrollment 

5 Notification and Eligibility Simplification Act of 2019’’ or 

6 the ‘‘BENES Act of 2019’’. 


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1 SEC. 2. BENEFICIARY ENROLLMENT NOTIFICATION AND 

2 ELIGIBILITY SIMPLIFICATION. 

3 (a) ELIGIBILITY AND ENROLLMENT NOTICES.— 

4 (1) AS PART OF SOCIAL SECURITY ACCOUNT

5 STATEMENT FOR INDIVIDUALS AGE 60 TO 65.—Sec6 tion 1143(a) of the Social Security Act (42 U.S.C. 

7 1320b–13(a)) is amended by adding at the end the 

8 following new paragraph: 

9 ‘‘(4) MEDICARE ELIGIBILITY INFORMATION.— 

10 ‘‘(A) IN GENERAL.—In the case of state11 ments provided on or after the date that is 2 

12 years after the date of the enactment of this 

13 Act to individuals who have attained 60 years 

14 of age but have not attained 65 years of age, 

15 the statement shall also include a notice con16 taining the information described in subpara17 graph (B). 

18 ‘‘(B) CONTENTS OF NOTICE.—The notice 

19 required under subparagraph (A) shall contain 

20 information on (including a clear, simple expla21 nation of)— 

22 ‘‘(i) eligibility for benefits under the 

23 Medicare program under title XVIII, and 

24 in particular benefits under part B of such 

25 title; 


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1 ‘‘(ii) the possibility of a late enroll2 ment penalty for failure to timely enroll 

3 (including the process for requesting relief 

4 under section 1837(h) in plain language); 

5 ‘‘(iii) the need for coordination of ben6 efits under such part B (including primary 

7 and secondary coverage scenarios) imposed 

8 under title XVIII; and 

9 ‘‘(iv) populations, such as veterans, 

10 for whom there are special considerations 

11 with respect to enrollment under this title. 

12 ‘‘(C) DEVELOPMENT OF NOTICE.— 

13 ‘‘(i) IN GENERAL.—The Secretary, in 

14 consultation with representatives of each of 

15 the groups described in subparagraph 

16 (D)(i), and in coordination with the Com17 missioner of Social Security, shall develop 

18 the notice to be provided pursuant to sub19 paragraph (A). 

20 ‘‘(ii) NOTICE IMPROVEMENT.—The 

21 Secretary, not less than once every two 

22 years, shall— 

23 ‘‘(I) review the content of the no24 tice to be provided under subpara25 graph (A); and 


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1 ‘‘(II) update and revise such no2 tice as the Secretary deems appro3 priate. 

4 ‘‘(D) GROUPS FOR CONSULTATION.— 

5 ‘‘(i) IN GENERAL.—For purposes of 

6 subparagraph (C), the groups described in 

7 this clause include the following: 

8 ‘‘(I) Individuals who are more 

9 than 60 years of age. 

10 ‘‘(II) Veterans. 

11 ‘‘(III) Individuals with disabil12 ities. 

13 ‘‘(IV) Individuals with end stage 

14 renal disease. 

15 ‘‘(V) Low-income individuals and 

16 families. 

17 ‘‘(VI) Employers (including 

18 human resources professionals). 

19 ‘‘(VII) States (including rep20 resentatives of State-run Health In21 surance Exchanges, Medicaid offices, 

22 and Departments of Insurance). 

23 ‘‘(VIII) State Health Insurance 

24 Assistance Programs. 

25 ‘‘(IX) Health insurers. 


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1 ‘‘(X) Health insurance agents 

2 and brokers. 

3 ‘‘(XI) Such other groups as spec4 ified by the Secretary. 

5 ‘‘(ii) NONAPPLICATION OF FACA.— 

6 The Federal Advisory Committee Act shall 

7 not apply to consultations made pursuant 

8 to subparagraph (C) with groups described 

9 in clause (i). 

10 ‘‘(E) POSTING OF NOTICE ON WEBSITES.— 

11 The Commissioner of Social Security and the 

12 Secretary shall each ensure that the notice 

13 being used under subparagraph (A) is posted in 

14 a prominent location on their respective Depart15 ment Internet website.’’. 

16 (2) INDIVIDUALS IN MEDICARE WAITING PE17 RIOD.—Title XI of the Social Security Act is amend18 ed by inserting after section 1144 the following new 

19 section: 

20 ‘‘MEDICARE ENROLLMENT NOTIFICATION AND ELIGI21 BILITY NOTICES FOR INDIVIDUALS IN MEDICARE

22 WAITING PERIOD

23 ‘‘Notices 

24 ‘‘SEC. 1144A. (a) 

25 ‘‘(1) IN GENERAL.—The Commissioner of So26 cial Security, in coordination with the Secretary, 


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1 shall distribute the notice developed and used by the 

2 Commissioner under section 1143(a)(4) to individ3 uals in the Medicare waiting period under section 

4 226(b) of this Act. 

5 ‘‘(2) AUTHORITY TO MODIFY NOTICE.—The 

6 Secretary, in coordination with the Commissioner of 

7 Social Security, may modify the notice to be distrib8 uted under paragraph (1) as necessary to take into 

9 account the population receiving the notice. 

10 ‘‘(3) POSTING OF NOTICE ON WEBSITES.—The 

11 Commissioner of Social Security and the Secretary 

12 shall each ensure that the notice being distributed 

13 under paragraph (1) is posted in a prominent loca14 tion on their respective Department Internet 

15 website. 

16 ‘‘Timing 

17 ‘‘(b) Beginning two years after the date of the enact18 ment of this section, a notice required under subsection 

19 (a)(1) shall be mailed to an individual no less than two 

20 times in accordance with the following: 

21 ‘‘(1) The notice shall be provided to such indi22 vidual no later than 3 months prior to the date of 

23 such individual’s enrollment period as provided 

24 under section 1837. 


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1 ‘‘(2) The notice shall subsequently be provided 

2 to such individual no later than one month prior to 

3 such date.’’. 

4 (b) BENEFICIARY MEDICARE PART B ENROLLMENT

5 PERIODS AND EFFECTIVE DATE OF COVERAGE.— 

6 (1) EFFECTIVE DATES.—Section 1838(a) of the 

7 Social Security Act (42 U.S.C. 1395q(a)) is amend8 ed— 

9 (A) by amending paragraph (2) to read as 

10 follows: 

11 ‘‘(2)(A) in the case of an individual who enrolls 

12 pursuant to subsection (d) of section 1837 before 

13 the month in which he first satisfies paragraph (1) 

14 or (2) of section 1836, the first day of such month; 

15 ‘‘(B) in the case of an individual not described 

16 in subparagraph (A) who first satisfies such para17 graph in a month beginning before January 2021 

18 and who enrolls— 

19 ‘‘(i) pursuant to such subsection (d) in 

20 such month in which he first satisfies such 

21 paragraph, the first day of the month following 

22 the month in which he so enrolls; 

23 ‘‘(ii) pursuant to such subsection (d) in the 

24 month following such month in which he first 

25 satisfies such paragraph, the first day of the 


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1 second month following the month in which he 

2 so enrolls; or 

3 ‘‘(iii) pursuant to such subsection (d) more 

4 than one month following such month in which 

5 he satisfies such paragraph, the first day of the 

6 third month following the month in which he so 

7 enrolls; 

8 ‘‘(C) in the case of an individual not described 

9 in subparagraph (A) who first satisfies such para10 graph in a month beginning on or after January 1, 

11 2021, and who enrolls pursuant to such subsection 

12 (d) in such month in which he first satisfies such 

13 paragraph or in any subsequent month of his initial 

14 enrollment period, the first day of the month fol15 lowing the month in which he so enrolls; 

16 ‘‘(D) in the case of an individual not described 

17 in subparagraph (A) who enrolls pursuant to sub18 section (e) of section 1837 in a month beginning be19 fore October 15, 2020, the July 1 following the 

20 month in which he so enrolls; or 

21 ‘‘(E) in the case of an individual not described 

22 in subparagraph (A) who enrolls pursuant to sub23 section (e) of section 1837 in a month beginning on 

24 or after October 15, 2020, the first day of the 


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1 month following the month in which he so enrolls.’’; 

2 and 

3 (B) by amending paragraph (3) to read as 

4 follows: 

5 ‘‘(3)(A) in the case of an individual who is 

6 deemed to have enrolled on or before the last day of 

7 the third month of his initial enrollment period, the 

8 first day of the month in which he first meets the 

9 applicable requirements of section 1836 or July 1, 

10 1973, whichever is later; 

11 ‘‘(B) in the case of an individual who is deemed 

12 to have enrolled on or after the first day of the 

13 fourth month of his initial enrollment period begin14 ning before January 1, 2021, as prescribed under 

15 subparagraphs (B)(i), (B)(ii), (B)(iii), and (D) of 

16 paragraph (2) of this subsection; or 

17 ‘‘(C) in the case of an individual who is deemed 

18 to have enrolled on or after the first day of the 

19 fourth month of his initial enrollment period begin20 ning on or after January 1, 2021, as prescribed 

21 under paragraph (2)(C) of this subsection.’’. 

22 (2) GENERAL AND SPECIAL ENROLLMENT PERI23 ODS.—Section 1837(e) of the Social Security Act 

24 (42 U.S.C. 1395p(e)) is amended to read as follows: 

25 ‘‘(e) ENROLLMENT PERIODS.— 


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1 ‘‘(1) FOR COVERAGE DURING YEARS BEFORE

2 2022.—There shall be a general enrollment period 

3 during the period beginning on January 1 and end4 ing on March 31 of each year before 2022. 

5 ‘‘(2) FOR COVERAGE DURING YEARS BEGINNING

6 WITH 2022.—For coverage during years beginning 

7 with 2022 and each subsequent year, there shall be 

8 a general enrollment period beginning on October 15 

9 of the previous year through December 31 of such 

10 previous year. 

11 ‘‘(3) EXCEPTIONAL CIRCUMSTANCES.—The 

12 Secretary may establish a special enrollment period 

13 in the case that an individual meets such exceptional 

14 conditions as the Secretary may provide.’’. 

15 (3) TECHNICAL CORRECTION.— 

16 (A) IN GENERAL.—Section 1839(b) of the 

17 Social Security Act (42 U.S.C. 1395r(b)) is 

18 amended by striking ‘‘close of the enrollment 

19 period’’ each place it appears and inserting 

20 ‘‘close of the month’’. 

21 (B) EFFECTIVE DATE.—The amendment 

22 made by subparagraph (A) shall take effect on 

23 November 1, 2021. 

Æ 


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