The Medicare Enrollment Protection Act of 2025 creates a special enrollment period for Medicare Part B for individuals enrolled in COBRA, ensuring they are not penalized for delaying enrollment and updating COBRA notices to explain Medicare's role.
Lloyd Smucker
Representative
PA-11
The Medicare Enrollment Protection Act of 2025 creates a one-time special enrollment period for Medicare Part B for individuals enrolled in COBRA, allowing enrollment during COBRA coverage and for three months after it ends. It ensures that these individuals will not face increased Medicare Part B premiums and protects their COBRA benefits by clarifying that these benefits should not be reduced or terminated for those eligible for, but not enrolled in, Medicare Part B. The Act also mandates updated COBRA continuation coverage notices to explain Medicare secondary payer rules and their application to COBRA.
New Bill Creates Special Medicare Sign-Up Window for COBRA Users Starting 2026, Ends Late Penalties
This bill, the Medicare Enrollment Protection Act of 2025, aims to smooth out a tricky transition point for many people: moving from job-based health insurance continued under COBRA to Medicare Part B. Starting January 1, 2026, it establishes a new, one-time special enrollment period (SEP) allowing individuals to sign up for Medicare Part B while they have COBRA coverage and for three months after it ends, crucially, without facing the usual late enrollment premium penalties.
Navigating the COBRA-to-Medicare Handoff
Losing your job or transitioning out of employer-sponsored health insurance often means relying on COBRA to keep coverage. But figuring out when to jump to Medicare Part B if you become eligible during that time can be confusing and costly if you miss the window. This bill directly addresses that headache. Under Section 2, it amends the Social Security Act to create this dedicated SEP. Think of it like this: if you're 65 or older and using COBRA after leaving a job, you won't be penalized with higher Part B premiums for the rest of your life just because you didn't enroll the moment you were first eligible. The bill specifically amends Section 1839(b) of the Social Security Act to ensure these folks don't get hit with premium increases tied to delayed enrollment, accounting for the months they were covered by COBRA. Coverage under this new SEP will begin the month after you enroll.
Keeping Your COBRA Intact (If You Need It)
Another key change protects individuals who are eligible for Medicare Part B but haven't enrolled yet while still on COBRA. Sometimes, people might choose to stick with their COBRA plan temporarily. Section 2 clarifies that employers offering COBRA can't reduce or terminate those benefits just because the individual is eligible for Part B. Essentially, your COBRA plan should continue as if Medicare eligibility wasn't a factor, unless and until you actually enroll in Part B. This provides flexibility without forcing anyone onto Medicare prematurely.
Clearer Road Signs: Updated COBRA Notices
To help people understand these complex rules, the bill also mandates clearer communication. By January 1, 2026, the Department of Labor, working with Health and Human Services, must update the standard COBRA notices. These updated notices (required by amendments to ERISA, the Public Health Service Act, and the Internal Revenue Code) will need to explain how Medicare interacts with COBRA, specifically covering the 'Medicare Secondary Payer' rules. This means you should get a clearer picture upfront about which plan pays first if you happen to have both, helping you make informed decisions and avoid surprise medical bills.