Told wrong information by a federal employee about Part B enrollment?
Checked against the current rules on September 24, 2026.
A premium, subsidy, or penalty determination isn't final just because a notice says so — Social Security and CMS both follow specific rules, and a determination that doesn't square with those rules is exactly the kind of request that tends to succeed.
Here's what the rule actually requires, what usually turns a request around, and the deadline you're working against.
What the rule requires
Whether the government's own error, misrepresentation, or inaction caused you to miss Part B enrollment is governed by§ 407.32 Prejudice to enrollment rights because of Federal Government misrepresentation, inaction, or error.. Social Security generally cannot apply a stricter test than what these rules require.
This ground is narrower than it sounds, and it's worth being precise about who actually qualifies: it has to be Social Security, Medicare, or another federal employee or federally authorized representative — not an employer's HR department, an insurance broker, or an agent, even if what they told you was just as wrong and just as costly. That distinction is the single most common reason a request like this gets turned down, so identify specifically who you spoke to and in what capacity before filing — a name, a date, and how you reached them, if you have any of it.
Questions that decide it
Before you file, these are the facts that usually decide whether a request like this succeeds:
Was the wrong information specifically from Social Security, Medicare, or another federal employee or federally authorized representative — not an employer, broker, or insurance agent?
What a winning request has to show
A request that succeeds usually includes:
Anything documenting what you were told and by whom (notes, a letter, a reference number from the call) — § 407.32 relief is discretionary and specifically requires the error, misrepresentation, or inaction to have come from a federal employee or someone federally authorized to act on the government's behalf. (You or your family provide this.)42 CFR 407.32
This is a request, not an appeal
§ 407.32 equitable relief is discretionary — there's no formal appeal right and no fixed filing deadline stated in the corpus. File the request as soon as you can, with whatever documentation you have of what you were told and by whom, specifically identifying the federal employee or federally authorized representative involved (not an employer, broker, or insurance agent — those don't qualify).
Questions people ask
- Do I need a lawyer to file this?
- No. Most of these are filed directly with Social Security (by phone, mail, fax, or in person) or through CMS's own reconsideration process — no attorney or representative is required, though you may use one if you choose.
- What if I miss the deadline?
- Every level above allows a late filing for good cause — a reason beyond your control that kept you from filing on time. Explain the reason when you file; it's reviewed, not an automatic denial.
Sources — last checked September 24, 2026
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By CaseWhy Appeals editorial. See how this content is produced. Not legal advice. Not affiliated with or endorsed by Medicare, CMS, or any health plan. A product of CaseWhy LLC.
