Response to comment document (60-day)

CMS Response to Public Comments for CMS-10718, OMB 0938-1378

The Centers for Medicare and Medicaid Services (CMS) received comments on the Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form (CMS–10718, OMB 0938-1378), as outlined by the Federal Register notice dated November 7, 2025 from Medicare Advantage (MA) and Prescription Drug Plan (PDP) Organizations and other interested parties. This is the reconciliation of the comments.

Comment: A commenter expressed concerns about the lack of Spanish translation indicating that Section 2 on the model enrollment form is optional. The commenter highlighted how communication barriers lead to misunderstood health information and privacy concerns when individuals rely on family members for translation. The commenter recommended that CMS include a Spanish translation of the statement about the questions in Section 2 being optional on the model enrollment form to ensure Spanish-speaking Medicare enrollees have the same clear understanding of their right to not disclose information in Section 2 as English speakers.

Response: Thank you for your comment. Plans are required to translate and provide materials into any non-English language that is the primary language of at least 5 percent of the individuals in a plan’s service area (as determined by the service area of the particular plan benefit package). Plans may also make modifications to the model enrollment form to make their forms more accessible to Spanish speakers, if necessary.

Comment: A commenter suggested adding Safe at Home programs to instances where a Post Office Box may be accepted as a permanent residence address on the enrollment form. The commenter suggested revising the optional question “Does your spouse work?” in Section 2 to “Do you have a spouse who works?” The commenter also requests clarification about how the payment section can be modified in any way that plans choose to display their payment options, as well as clarification in guidance regarding the 5 percent threshold for translating materials into other languages.

Response: Thank you for your comment. Generally, the individual’s primary residence establishes proof of permanent residence, which plans use to evaluate and determine residency within the plan’s service area. If an individual puts a post office box as their place of residence on the enrollment form, the enrollment request is considered incomplete, and the plan must take additional steps to determine if the individual physically resides in the plan’s service area. We will consider your suggestion for future updates to our enrollment guidance on permanent residence address scenarios.

The question “Does your spouse work?” in Section 2 is optional. If the individual does not have a spouse, they may skip the question and leave the response blank. The plan may choose to revise the question to meet its business needs.

The enrollment form is considered a “model” under Medicare regulations for purposes of communication and marketing review and approval; therefore, MA and Part D plans are able to modify the language, content, format, or order of the enrollment form. Plans may modify the format of the payment section to display the appropriate payment options. Plans may also wish to refer to other exhibits in the Medicare Advantage Enrollment and Disenrollment Guidance appendices and exhibits for examples of how to display payment options. The regulations at §§ 422.2267(a)(2) and 423.2267(a)(2) still require plans to translate required materials into any non-English language that is the primary language of at least 5 percent of the individuals in a plan benefit package (PBP) service area. The Medicare Communications and Marketing Guidelines discuss the translation threshold requirement.

Comment: A commenter opposes the removal of voluntary demographic data questions from the Medicare Part C and D model enrollment form, as announced in a May 6, 2025 Health Plan Management System (HPMS) memo, and the decision to remove previously approved language translations from the collection of information. They ask that CMS provide a notice and comment period so that the public may comment on the removal of these demographic fields and CMS’s justification. The commenter also requests the reinstatement of voluntary race, ethnicity, sexual orientation, and gender identity questions on the model enrollment form. The comment also requests the reinstatement of the previously available language translations of the model enrollment form.

Response: Thank you for your comment. We removed the voluntary race, ethnicity, sexual orientation, and gender identity questions from the enrollment form to align with recent Executive Orders. The removal of these questions reduced plan burden and streamlined the enrollment process for individuals applying for Medicare Part C and D. These changes were submitted as non-substantive changes that were approved by the Office of Management and Budget (OMB). Agencies are not required to seek public comment on non-substantive changes.

We previously translated the model Part C and D enrollment form into Spanish, Chinese, Vietnamese, and Korean in response to Executive Orders 13985 and 13166. Those Executive Orders have recently been rescinded. As a result, we proposed to remove the translated materials from the PRA submission to reduce administrative burden associated with translating and reviewing additional versions of the model form. The regulations at §§ 422.2267(a)(2) and 423.2267(a)(2) still require plans to translate required materials into any non-English language that is the primary language of at least 5 percent of the individuals in a plan benefit package (PBP) service area. Plans may also choose to translate the model form into additional languages.