If CMS denies an enrollment request, what is the consumer's financial responsibility?

When the Centers for Medicare & Medicaid Services (CMS) denies an enrollment request, the consumer typically becomes responsible for all healthcare costs incurred during the period when they were seeking coverage but were ultimately denied enrollment. This scenario often occurs when individuals believe they are eligible for certain health plans or services, but due to the denial, they remain uninsured.

As a result, any medical expenses they incur during the timeframe of the denial will not be covered by a health insurance plan, leading to the consumer facing the full financial burden of those costs. It is essential for consumers to understand that without an active enrollment in a Medicare plan or other health insurance program, they are personally liable for any medical expenses they might incur, which underscores the importance of ensuring eligibility and completing the enrollment process successfully.