How to avoid Medicare Part D penalty
Hello Toni,
I read your column about how ignoring Medicare rules is costing Americans millions, and I believe I have made a mistake because I have not enrolled in a Medicare Part D prescription drug plan. I need your help!
I retired in August and had a telemarketing agent help me find a Medicare supplement that began Sept. 1. No one told me that I had a specific amount of time to enroll in my Medicare Part D plan. Currently, my prescriptions are generic, and I use GoodRx to receive a discount.
When I enrolled Dec. 15 for a new Medicare Part D plan, I was denied because I did not apply on time.
I am 70, and my Part D will begin next year when I’m 71. Medicare informed me the Part D penalty will be $0.3470 X 72 months since my Medicare Part A began six years ago at 65. I cannot believe that I must pay an extra $25 per month as a
Part D “penalty.”
Please explain this ridiculous Medicare Part D rule and when I can begin my plan. Thank you.
— Samuel from Chattanooga.
Samuel,
Because you missed the 2024 Medicare annual enrollment period, you will have to wait until the next annual enrollment period, from Oct. 15 to Dec. 7, to enroll in a Medicare Part D plan. Your effective date will be Jan. 1, 2025.
The good news is you are currently taking generics and can use GoodRx (which is not what Medicare deems as a “creditable” prescription drug plan) until you enroll in Medicare Part D during that time. (Chapter
5 of the Toni Says “Medicare Survival Guide Advanced” edition, explains Medicare Part D, how to avoid Part D penalties and the famous doughnut hole.)
Once you are past 65 and leaving creditable employer’s group coverage with a prescription drug plan, Medicare gives you only 63 days, not 90 days, not eight months, but less than 63 days to enroll in Medicare Part D or a Medicare Advantage plan with prescription drug coverage.
Your late enrollment period did not begin from the day you left your company health plan, nor from your Medicare Part B start date. It began from the month your Medicare Part A began.
The late enrollment period for Medicare Part D can be charged to you because:
› You waited past 63 days without creditable prescription drug coverage upon leaving company benefits and you are older than 65 years and 90 days. Readers, do not wait past 63 days to get Medicare Part D upon leaving company health insurance.
› Your company prescription drug benefits (not health insurance) were not “creditable” as Medicare declares.
› You never enrolled in Medicare Part D at the time you enrolled in Medicare Part A and Part B when you turned 65, and now want to enroll.
Samuel, you were denied Medicare Part D prescription coverage because you met Medicare’s late enrollment period and will receive the Part D penalty when you enroll during Medicare’s annual enrollment period — a penalty that lasts a lifetime.
Americans retiring after 65 who are leaving their employer’s health plans and applying for Medicare Parts A and B must also prove they have “creditable coverage” when applying for a Medicare Part D prescription drug plan. This is a Medicare rule. Don’t delay your Part D enrollment.
Readers: Last week’s Medicare article, “Ignoring Medicare rules costs Americans millions in penalties,” contained an error. The Medicare Part D penalty is based on 1% for each month, not year, for which one could have but failed to enroll in Medicare Part D.
Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Toni’s books and her newsletter are available at www.tonisays.com. Toni’s new “Confused about Medicare” video series is now available for purchase at www.tonisays.com, as are Toni’s “Medicare Survival Guide” and discounted bundle package.