The Centers for Medicare & Medicaid Services (CMS) announced today that same-sex spouses will be recognized in administering several aspects of the Medicare program, regardless of where the couple lives. CMS works with the Social Security Administration to conduct eligibility determinations and to enroll seniors and individuals with certain disabilities in the program. Social Security updated their own marriage recognition policies earlier this week to streamline the handling of marriage-based claims involving transgender people. The announcement is the latest step implementing the Supreme Court’s decision overturning the Defense of Marriage Act (DOMA).
Social Security will now begin processing Medicare enrollment, requests for Special Enrollment Periods, and requests for reductions in late-enrollment penalties for many same-sex spouses. Eligibility for Medicare Part A and Part B coverage is particularly important for these families, who are disproportionately likely to be uninsured. Medicare Part A coverage is often available without paying a monthly premium, making it important for the many lesbian, gay, and bisexual people who struggle to afford coverage.
CMS’s decision also impacts some people who previously applied for a Special Enrollment Period but were denied eligibility because of DOMA. For some of these couples, Social Security will be able to approve a second request for a Special Enrollment Period, giving more immediate access to Medicare coverage.
For couples in domestic partnerships or civil unions this announcement offers some, but not all of the same opportunities for enrolling in Medicare coverage. Domestic partnerships and civil unions are not recognized for the purposes of Special Enrollment Periods for applicants 65 or older, but for those applicants with disabilities who are under 65, Special Enrollment Periods are available as long as the applicant has coverage through their partner’s current employer.
The Department of Health and Human Services (HHS) and CMS have been acting to implement the Windsor decision since last year, expanding coverage for many same-sex couples. HHS announced last month that plans sold through Marketplaces established by the Affordable Care Act must offer coverage to all same-sex spouses starting in 2015. In September of last year, CMS sent a letter to state Medicaid directors granting discretion to recognize same-sex marriages according to the laws of their state.
Read the full Medicare announcement here.