119-hr4960

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4960 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4960

 To amend title XVIII of the Social Security Act to establish a system 
 to notify individuals approaching Medicare eligibility.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 August 12, 2025

 Mr. Ruiz (for himself, Mr. Evans of Pennsylvania, Mr. Bilirakis, and 
Mr. Schneider) 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.

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

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Beneficiary Enrollment Notification 
and Eligibility Simplification 2.0 Act'' or the ``BENES 2.0 Act''.

SEC. 2. BENEFICIARY ENROLLMENT NOTIFICATION AND ELIGIBILITY 
 SIMPLIFICATION.

    (a) Eligibility and Enrollment Notices.--

    (1) As part of social security account statement for 
 individuals attaining ages 60 to 65.--
        (A) In general.--

Section 1143

    (a) of the Social 
 Security Act (42 U.S.C. 1320b-13

    (a) ) is amended by 
 adding at the end the following new paragraph:
 ``

    (4) Medicare Eligibility Information.--
 ``
        (A) In general.--In the case of statements provided on or 
 after the date that is 2 years after the date of the enactment 
 of this paragraph to individuals who are attaining ages 60, 61, 
 62, 63, 64 and 65, the statement shall also include a notice 
 containing the information described in subparagraph
        (B) .
 ``
        (B) Contents of notice.--The notice required under 
 subparagraph
        (A) shall include a clear, simple explanation of--
 ``
            (i) eligibility for benefits under the Medicare 
 program under title XVIII, and in particular benefits 
 under part B of such title;
 ``
            (ii) the reasons a late enrollment penalty for 
 failure to timely enroll could be assessed and how such 
 late enrollment penalty is calculated, in particular 
 for benefits under such part B;
 ``
            (iii) the availability of relief from such late 
 enrollment penalty and retroactive enrollment under 
 

section 1837

    (h) (including as such section is applied 
 under sections 1818
            (c) and 1818A
            (c) (3) ), with examples 
 of circumstances under which such relief may be granted 
 and examples of circumstances under which such relief 
 would not be granted;
 ``
            (iv) coordination of benefits (including primary 
 and secondary coverage scenarios) pursuant to 

section 1862

    (b) , in particular for benefits under such part B;
 ``
            (v) enrollment, eligibility, and coordination of 
 benefits under title XVIII with respect to populations, 
 for whom there are special considerations, such as 
 residents of Puerto Rico and veterans; and
 ``
            (vi) online resources and toll-free telephone 
 numbers of the Social Security Administration and the 
 Centers for Medicare & Medicaid Services (including 1-
 800-MEDICARE and the national toll-free number of the 
 Social Security Administration) that provide 
 information on eligibility for benefits under the 
 Medicare program under title XVIII.
 ``
            (C) Development of notice.--
 ``
            (i) In general.--The Secretary, in coordination 
 with the Commissioner of Social Security, and taking 
 into consideration information collected pursuant to 
 clause
            (ii) , shall, not later than 12 months after the 
 last day of the period for the request of information 
 described in clause
            (ii) , develop the notice to be 
 provided pursuant to subparagraph
        (A) .
 ``
            (ii) Request for information.--Not later than 6 
 months after the date of the enactment of this 
 paragraph, the Secretary shall request written 
 information, including recommendations, from 
 stakeholders (including the groups described in 
 subparagraph
            (D) ) on the information to be included in 
 the notice.
 ``
            (iii) Notice improvement.--Beginning 4 years 
 after the date of the enactment of this paragraph, and 
 not less than once every 2 years thereafter, the 
 Secretary, in coordination with the Commissioner of 
 Social Security, shall--
 ``
            (I) review the content of the notice to 
 be provided under subparagraph
        (A) ;
 ``
            (II) request written information, 
 including recommendations, on such notice 
 through a request for information process as 
 described in clause
            (ii) ; and
 ``
            (III) update and revise such notice as 
 the Secretary deems appropriate.
 ``
            (D) Groups.--For purposes of subparagraph
            (C) 
            (ii) , the 
 groups described in this subparagraph include the following:
 ``
            (i) Individuals who are 60 years of age or older.
 ``
            (ii) Veterans.
 ``
            (iii) Individuals with disabilities.
 ``
            (iv) Individuals with end stage renal disease.
 ``
            (v) Low-income individuals and families.
 ``
            (vi) Employers (including human resources 
 professionals).
 ``
            (vii) States (including representatives of State-
 run Health Insurance Exchanges, Medicaid offices, and 
 Departments of Insurance).
 ``
            (viii) State Health Insurance Assistance 
 Programs.
 ``
            (ix) Health insurers.
 ``
            (x) Health insurance agents and brokers.
 ``
            (xi) Such other groups as specified by the 
 Secretary.
 ``
        (E) Posting of notice on websites.--The Commissioner of 
 Social Security and the Secretary shall post the notice 
 required under subparagraph
        (A) on the public internet website 
 of the Social Security Administration and on Medicare.gov (or a 
 successor website), respectively.
 ``
        (F) No effect on obligation to mail statements.--Nothing 
 in this paragraph shall be construed to relieve the 
 Commissioner of Social Security from any requirement under 
 subsection
            (c) , including the requirement to mail a statement 
 on an annual basis to each eligible individual who is not 
 receiving benefits under title II and for whom a mailing 
 address can be determined through such methods as the 
 Commissioner determines to be appropriate.''.
        (B) Timing of statements.--

Section 1143
            (c) (2) of 
 the Social Security Act (42 U.S.C. 1320b-13
            (c) (2) ) is 
 amended by adding at the end the following new 
 sentence: ``With respect to statements provided to 
 individuals who are attaining age 65, as described in 
 subsection

    (a)

    (4) , such statements shall be mailed not 
 earlier than 6 months and not later than 3 months 
 before the individual attains such age.''.

    (2) Social security beneficiaries.--Title XI of the Social 
 Security Act (42 U.S.C. 1301 et seq.) is amended by inserting 
 after 

section 1144 the following new section:

``

SEC. 1144A. MEDICARE ENROLLMENT NOTIFICATION AND ELIGIBILITY NOTICES 
 FOR SOCIAL SECURITY BENEFICIARIES PRIOR TO MEDICARE 
 ELIGIBILITY.

 ``

    (a) Notices.--
 ``

    (1) In general.--The Commissioner of Social Security 
 shall distribute the notice to be provided pursuant to 

section 1143

    (a)

    (4) , as may be modified under paragraph

    (2) , to 
 individuals entitled to monthly insurance benefits under title 
 II in accordance with subsection

    (b) .
 ``

    (2) Authority to modify notice.--The Secretary, in 
 coordination with the Commissioner of Social Security, may 
 modify the notice to be distributed under paragraph

    (1) as 
 necessary to take into account the individuals described in 
 such paragraph.
 ``

    (3) Posting of notice on websites.--The Commissioner of 
 Social Security and the Secretary shall post the notice 
 required to be distributed under paragraph

    (1) on the public 
 internet website of the Social Security Administration and on 
 Medicare.gov (or a successor website), respectively.
 ``

    (b) Timing.--Beginning not later than 2 years after the date of 
the enactment of this section, a notice required under subsection

    (a)

    (1) shall be mailed to an individual described in such subsection--
 ``

    (1) in the third month before the date on which such 
 individual's initial enrollment period begins as provided under 
 

section 1837; and
 ``

    (2) in the case of an individual with respect to whom 
 

section 226

    (b) applies (except for an individual who will 
 attain age 65 during the 24 month period described in such 
 section), in the month before such date on which such 
 individual's initial enrollment period so begins.''.
 <all>