Some Patients' Medicare Can End on February 1, 2027. The Eligibility Check Will Show It Before the Claim Does.

Section 71201 of Public Law 119-21, which the Centers for Medicare & Medicaid Services (CMS) calls the Working Families Tax Cut legislation, changes who can have Medicare. On November 10, 2026, the Social Security Administration (SSA) said it would start this week to apply the new rule to Medicare applications and to notify current beneficiaries whose eligibility it cannot confirm.

Those patients are told their Medicare "may end February 1, 2027," unless they establish eligibility within the time given in the notice. CMS repeated the point to providers in its November 12 MLN Connects newsletter: terminations will happen no earlier than February 1, 2027, and each patient's notice gives the end date.

Who keeps Medicare under the new law

Under the law, a person can be entitled to or enrolled in Medicare only if they are in one of four groups. They must also meet every other Medicare requirement, such as age or disability.

• A U.S. citizen or national.
• A lawful permanent resident (green card holder).
• A Cuban-Haitian entrant.
• A Compact of Free Association migrant (from Micronesia, the Marshall Islands or Palau).

Before this law, other lawfully present people could also have Medicare. The Congressional Research Service listed refugees, people granted asylum, certain parolees, people with Temporary Protected Status and people with deferred action among them. Those are the patients most likely to get a notice. SSA says Social Security benefits themselves do not change.

Why this lands on the front desk

A patient whose Medicare ends on February 1 can still keep a February appointment. If nobody checks eligibility, the visit is billed to Medicare, the claim is denied, and the practice learns about it weeks later. By then the patient has left without a payment discussion.

CMS gives the answer itself: Original Medicare providers can see a patient's eligibility in the HIPAA Eligibility Transaction System (HETS). For Medicare Advantage patients, CMS says the plans will inform their providers about their enrollees' eligibility. So the warning reaches you through two different doors, and both need someone watching.

Five checks before February

This is general information, not legal advice. A practice can start with these steps:

• Run a fresh eligibility check for every Medicare patient with a visit on or after February 1, 2027, not only new patients. A check from last year's intake is not proof of coverage this February.
• Look again at monthly and recurring services, such as care management or standing therapy visits. Check eligibility at the start of each month, before the service is billed.
• Ask your Medicare Advantage plans how they will tell you about affected members, and who in your office receives those notices.
• If a patient mentions a Social Security letter, encourage them to read it and respond by the deadline. SSA lets them upload documents in a my Social Security account, visit a local office, or call 1-844-507-7131. Your staff should not give immigration advice.
• When a check shows coverage has ended, have the self-pay conversation before the visit, and do not send the claim to Medicare.

What patients who lose coverage are told

CMS lists a few paths: coverage through the patient's or a spouse's employer, state social services programs, community health centers, and the HealthCare.gov Marketplace. CMS also warns that people not eligible for Medicare because of immigration status are not eligible for any help paying for a Marketplace plan. Some of these patients may become self-pay, and your front desk should be ready for that conversation.

Most Medicare patients will see no change. The work is to find the few who do before their claims are denied. If you want to see how eligibility denials show up in your own claims, a revenue review can look at one payer and one quarter.