What Does Equitable Relief Mean?

If you didn’t sign up for Medicare Part B and you believe someone else is responsible for the error, you may be eligible for Medicare equitable relief. Read on to learn exactly what Medicare equitable relief is, who’s eligible, how to request it, and more. 

What Is Medicare Equitable Relief?
Medicare equitable relief allows you to request the following from the Social Security Administration (SSA): 

  • Immediate or retroactive Medicare enrollment
  • Elimination of the Medicare Part B late enrollment penalty (LEP)

Who is eligible for Medicare equitable relief?
You’re eligible for Medicare equitable relief if you failed to enroll in Medicare Part B due to the error, inaction, or misrepresentation of a federal agent, such as a Social Security representative. For instance, if you didn’t enroll in Medicare Part B because an agent from 1-800-MEDICARE (1-800-633-4227) said, incorrectly, that you couldn’t sign up until next year, you might be eligible for equitable relief. 

But Medicare equitable relief does not apply if you were misinformed about your options and rights by a non-federal representative, such as your employer or doctor. 

How Can I Request Medicare Equitable Relief?
You or your federal representative need to explain your situation in a written letter to your local Social Security office. The letter should state that you received misinformation that caused you to delay enrollment for Medicare Part B. Other important details to include in the letter are listed below:

  • Include the name of the representative with whom you spoke. 
  • Include the date and time of your conversation with the representative. 
  • Indicate whether you want coverage going forward, retroactive coverage, and/or elimination of the Part B Late Enrollment Penalty. 
  • Include any additional notes that may be helpful for the Social Security office. 

To find the address of your local Social Security office, call 800-772-1213 or visit www.ssa.gov/locator.  

Can Medicare Part B Be Backdated?
Yes, if the SSA grants your equitable relief request, your Medicare Part B can be backdated. However, you should be aware that if you do request retroactive coverage, you’ll be expected to pay premiums back to the time your coverage begins.

When Will  I Hear Back About My Request for Medicare Equitable Relief?
Social Security is not required to respond to equitable relief requests within any set timeframe. It’s also not required to send you a formal decision letter in response to your request. If you don’t hear anything for a month from the date you submitted your request for Medicare equitable relief, consider contacting a legislative representative, such as your member of Congress. He or she may be able to check on the status of your request.

What If I’m Denied Medicare Equitable Relief?
If you’re denied equitable relief, there’s no formal appeal process. But you can resubmit your request with more or different information as many times as you’d like. 

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