Equitable relief

Original Medicare enrollment

Equitable relief is a process that 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)

To request equitable relief, you must have failed to enroll in Medicare due to the error, misrepresentation, or inaction of a federal employee, such as a Social Security or 1-800-MEDICARE representative. Equitable relief does not apply if you were misinformed about your Medicare rights and options by non-federal employees, such as an employer.

For example, let’s say you did not enroll in Part B because a Social Security representative said you did not need to sign up. Because you failed to enroll due to an error caused by misinformation from a federal employee, you may have grounds for receiving equitable relief.

Requesting equitable relief

To request equitable relief, you or your representative should write a letter to your local Social Security office explaining that you received misinformation that caused you to delay enrollment. You can find the address of your local office by calling 800-772-1213 or visiting www.ssa.gov/locator.

Be as specific as possible in your letter, and include the name of the representative you spoke to, date and time of the conversation, outcome of the conversation, and any additional notes.

You should also indicate whether you want coverage going forward, retroactive coverage, and/or elimination of your Part B LEP. Keep in mind that if you request retroactive coverage, you will have to pay premiums back to the time your coverage begins.

Troubleshooting

Social Security is not required to respond to equitable relief requests within any set timeframe. They also do not have to send you a formal decision letter in response to your request.

Follow up with your local Social Security office around one month after submitting your request. You may also want to contact a legislative representative, such as a member of Congress, and ask them to follow up on the case. If you are denied equitable relief, there is no formal appeal process, but you can resubmit your request with more or different information as many times as you wish.