HR4960-119

Introduced

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

119th Congress Introduced Aug 12, 2025

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

The Beneficiary Enrollment Notification and Eligibility Simplification 2.0 Act (BENES 2.0) creates a notification system to help people approaching Medicare eligibility understand their enrollment options and avoid costly mistakes. It requires that Social Security account statements for individuals ages 60 through 65 include clear explanations of Medicare eligibility, enrollment deadlines, late enrollment penalties, and how Medicare coordinates with other insurance. A separate notice goes to people already receiving Social Security benefits before they reach Medicare eligibility.

Who Benefits and How

Americans approaching age 65 benefit from proactive, clear information about Medicare enrollment, helping them avoid late enrollment penalties that can permanently increase their Part B premiums. Veterans and residents of Puerto Rico, who face special enrollment considerations, are specifically addressed. People with disabilities approaching Medicare eligibility through Social Security also receive targeted notifications. The bill requires stakeholder input from seniors, veterans, disability groups, employers, health insurers, and state programs to design effective notices.

Who Bears the Burden and How

The Social Security Administration bears the administrative burden of producing and mailing the additional notices. The Department of Health and Human Services (specifically CMS) must develop the notice content in coordination with SSA, conduct stakeholder outreach, and review and update the notices every two years. Both agencies must post notices on their public websites.

Key Provisions

  • Adds Medicare eligibility information to Social Security statements for individuals ages 60-65
  • Requires clear explanations of Part B enrollment, late penalties, penalty relief options, and benefits coordination
  • Creates a separate notification for Social Security beneficiaries approaching Medicare eligibility, mailed 3 months before their enrollment period begins
  • Mandates stakeholder input from 11 specified groups including seniors, veterans, disability advocates, employers, and health insurers
  • Requires notice content review and updating every 2 years starting 4 years after enactment
  • Posts all notices on SSA and Medicare.gov websites

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

Establishes a system to notify individuals approaching Medicare eligibility about enrollment options, deadlines, late penalties, and coordination of benefits, by adding Medicare information to Social Security account statements for people ages 60-65 and creating a separate notification process for Social Security beneficiaries.

Key Policy Areas

Healthcare, Social Security

Primary Purpose

Establishes a system to notify individuals approaching Medicare eligibility about enrollment options, deadlines, late penalties, and coordination of benefits, by adding Medicare information to Social Security account statements for people ages 60-65 and creating a separate notification process for Social Security beneficiaries.

Policy Domains

Healthcare Social Security

Whole Bill

Identified Gains
  • Americans approaching age 65 (Medicare enrollment guidance)
  • Veterans and Puerto Rico residents (special enrollment considerations)
  • Individuals with disabilities approaching Medicare eligibility
Model: N/A | Version: bill_summary_v2 | Source: ih
Americans approaching age 65 (Medicare enrollment guidance):
Individuals with disabilities approaching Medicare eligibility:
Veterans and Puerto Rico residents (special enrollment considerations):
Identified Costs
  • Social Security Administration (mailing and distribution)
  • Department of Health and Human Services / CMS (notice development and updates)
Model: N/A | Version: bill_summary_v2 | Source: ih
Social Security Administration (mailing and distribution): ,
Department of Health and Human Services / CMS (notice development and updates):

Legislative Progress

Introduced
Introduced Committee Passed
Aug 12, 2025

Mr. Ruiz (for himself, Mr. Evans of Pennsylvania, Mr. Bilirakis, …

Impact analysis is available but no clear stakeholder effects identified. View clause-level analysis →

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Social Security
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
"the_commissioner"
→ Commissioner of Social Security

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology