Social Security Administration Begins Medicare Eligibility Reviews: Beneficiaries Who Cannot Confirm Their Status Must Submit Proof or Lose Coverage on February 1, 2027
The U.S. Social Security Administration (SSA) announced on November 10 that it has begun reviewing eligibility for Medicare under Section 71201 of Public Law 119-21: only people in four status categories may be entitled to or enrolled in Medicare. Starting this week, the agency is notifying current beneficiaries whose eligibility it cannot confirm, and those who receive a notice must submit proof of U.S. citizenship or an eligible immigration status by the deadline given, or their coverage may end as early as February 1, 2027.
Under the new law, the four eligible categories are U.S. citizens or nationals; lawful permanent residents (green card holders); Cuban-Haitian entrants; and citizens of the Federated States of Micronesia, the Republic of the Marshall Islands and Palau who are lawfully residing in the United States under the Compacts of Free Association. SSA enrolls people in Medicare on behalf of the Centers for Medicare & Medicaid Services (CMS) and follows CMS rules based on the law. The agency stressed that the changes do not affect Social Security benefit eligibility or payment rules.
For people already covered, insurance does not end right away: those who are not eligible under the new rules will generally keep their Medicare through January 31, 2027, with termination effective February 1, 2027. This week SSA began both applying the new requirements to Medicare applications and enrollments, and notifying current beneficiaries whose eligibility it cannot confirm that their coverage may end on February 1, 2027, unless they establish eligibility within the applicable timeframe.
Anyone who receives a notice should read it carefully and respond by the deadline provided. Evidence of U.S. citizenship includes a U.S. passport or a Certificate of Naturalization; evidence of immigration status includes a Permanent Resident Card (Form I-551), an Arrival/Departure Record (Form I-94) or an Employment Authorization Document (Form I-766). Documents can be submitted by signing in to a personal my Social Security account and selecting Upload Documents, by bringing the documents to a local Social Security office, or by calling 1-844-507-7131 from inside the United States or 855-522-6939 from outside the country; the TTY number for people who are deaf or hard of hearing is 1-800-325-0778, and callers should mention the letter.
Beneficiaries whose Medicare is terminated or denied may appeal in writing within 60 days of receiving the decision letter, using SSA's online Non-Medical Appeal form or the Request for Reconsideration form, SSA-561-U2. People who later obtain an eligible immigration status may contact Social Security about Medicare at that time. For those who do not qualify under the new criteria, SSA suggests contacting their state's Social Services office about state programs that help immigrants obtain other health insurance, considering a workplace health plan through their own or a spouse's job, and notes that community health centers may provide free or low-cost health care.
(Source: Social Security Administration)
Source: Social Security Administration
Published by GSM · USA (original Chinese edition)
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