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