When it comes to Medicare, it’s all about timing
Whether to sign up for Medicare when you first become eligible is a very important decision. What a lot of folks don’t realize is that Medicare Part A, Part B and Part D may have late enrollment penalties if you decide to delay enrollment.
Usually, you first become eligible for Original Medicare, Part A and Part B, when you turn 65. You have an Initial Enrollment Period that starts three months before you turn 65, includes the month of your 65th birthday, and ends three months later. Some people are eligible for Medicare before age 65 if they receive disability benefits for more than two years or have amyotrophic lateral sclerosis or end-stage renal disease.
For Medicare Part D, you are first eligible to enroll when you have Medicare Part A and/or Part B. Most of the time, your Initial Enrollment Period for Medicare Part D will take place at the same time as your Initial Enrollment Period for Original Medicare Part A and Part B.
Late enrollment penalties may apply when you enroll in Medicare Part A, Part B, or Part D after your Initial Enrollment Period. However, there are some situations where you can delay enrollment without facing a penalty. Medicare Part A Late Enrollment Penalty Most people get Medicare Part A premium free, if they have worked at least 10 years (40 quarters) and paid Medicare taxes during that time. If you don’t have enough work history, however, you may have to pay a premium for Medicare Part A.
If you pay a premium for Medicare Part A, make sure you sign up when you’re first eligible or this amount could be higher. The Medicare Part A late enrollment penalty is a 10 percent higher premium for twice the number of years that you were eligible, but didn’t sign up for Medicare Part A. For example, if you were eligible for Medicare Part A, but didn’t enroll for two years, you will have to pay a higher premium for four years (or twice the number of years that you were eligible for Part A, but went without it).
You may not have to pay this late enrollment penalty if you delayed enrollment because you had other health coverage, such as through your employer or through your spouse’s employer. If you sign up during a Special Enrollment Period, you can avoid the Medicare Part A penalty. Medicare Part B Late
Enrollment Penalty Unlike Medicare Part A, everyone pays a premium for Medicare Part B. But if you don’t sign up when you are first eligible and don’t have other health insurance, you could face a late enrollment penalty. The Medicare Part B late enrollment penalty is a 10 percent higher premium for each full 12-month period that you were eligible, but didn’t enroll in Medicare Part B. For example, let’s say your Initial Enrollment Period ended Januar y 15, 2015, but you waited until March 2017 during the General Enrollment Period to enroll. This period includes two full 12-month periods, so your Medicare Part B penalty would be 20 percent higher. Unlike Medicare Part A, you may have to pay this higher premium permanently for as long as you’re in Medicare.
Once again, if you delay Medicare Part B because you’re still working and have coverage through your employer or your spouse’s employer, you may not have to pay a late enrollment penalty if you sign up during your Special Enrollment Period.
Medicare Part D Late Enrollment Penalty
The Medicare Part D late enrollment penalty may apply if you don’t sign up when you are first eligible and don’t have other creditable prescription drug coverage for 63 or more days in a row. Creditable prescription drug coverage is other drug coverage that is expected to pay on average, as much as the standard Medicare Part D coverage.
The Medicare Part D penalty works differently and will depend on how long you went without creditable prescription drug coverage. It’s calculated by multiplying 1 percent of the national base beneficiary premium ($35.63 in 2017) by the number of full months you were eligible for Medicare Part D, but didn’t join and didn’t have creditable prescription drug coverage. This number is rounded to the nearest 10 cents and added to your Medicare Part D premium. You may have to pay this penalty for as long as you have Medicare Part D.
If you are in the Extra Help (Low-Income Subsidy) program, you won’t have to pay a late enrollment penalty for Medicare Part D.
To avoid the penalty, make sure your prescription coverage is creditable if you’re not enrolled in a Medicare Part D Prescription Drug Plan. Your plan should notify you every year whether your coverage is creditable.
A lot of folks think they are saving money by going without Medicare prescription drug coverage, especially if they only take a few medications. However, your costs may end up being higher in the long run if you get sick and need to pay the full cost for prescription drugs. Also, remember that your late enrollment penalty increases the longer you wait to enroll. If you don’t have other creditable prescription drug coverage, you might consider signing up for a basic, lower-cost Medicare Part D Prescription Drug Plan.
Mike Zimmer is President of Bay State Insurance Agency Ltd. in Centreville. He is available to answer your questions or speak to your groups regarding Medicare, Medicare Advantage, Medicare Supplements and Medicare Part D (Prescription Plans) He may be reached at 410-758-1680.