When to Apply for Medicare & How to Avoid Late Penalties

How to Avoid the Medicare Late Enrollment Penalty

GoMedigap
Home » Medicare Enrollment » How to Avoid the Medicare Late Enrollment Penalty

Medicare Late Enrollment Penalty

Are you nearing your 65th birthday? Three months before your big day, you’ll receive information in the mail about your Medicare Open Enrollment Period. Don’t let Medicare enrollment overwhelm you – you’ll have plenty of time to become a Medicare expert before it’s time for you to enroll. Your Open Enrollment Period lasts seven months: three months before, through the month of, and three months after your 65th birthday.

You may be wondering: what if I don’t enroll in Medicare during this time period? Unfortunately, you may be looking at some penalties. Medicare late enrollment penalties typically impact those who try to enroll in Medicare outside of their designated Open Enrollment Period.

What is the Medicare Late Enrollment Penalty?

As you’re doing your research, you’ll learn that there are four parts to Medicare: Medicare Part A, Part B, Part C, and Part D. There are different penalties for enrolling late into most of the different parts of Medicare. Let’s dive into the specific penalties for Part A, Part B, and Part D.

Medicare Part A Late Enrollment Penalty

Thankfully, most people don’t have to worry about enrolling in Medicare Part A. It’s common that you will automatically qualify for Medicare Part A when you turn 65. If this happens for you, you’ll typically receive Part A premium-free. How do you know if you’re eligible for automatic enrollment into premium-free Part A? Well, you are automatically eligible for a premium-free Part A if you or your spouse worked at least 40 quarters (10 years) in the United States.

There may be cases where you or your spouse might not meet the requirements to qualify for a premium-free Part A. If you find yourself in this position, don’t worry. However, it’s important that you enroll when you first become eligible. If not, you might be subject to the Medicare Part A late enrollment penalty. Unfortunately, this penalty increases your monthly premium by up to 10%. In most cases, you might have to pay this increased premium for double the number of years you could have had Part A but did not sign up.

Let’s give an example. If you qualified for Part A for three years but didn’t sign up until the third year, you would typically have to pay an increased premium for six years. That’s why it’s important to enroll as soon as possible: we want you to have that money that you’d pay in penalties, in your pocket instead.

Medicare Part B Late Enrollment Penalty

Much like Part A, many people receive automatic enrollment in Part B. This is most likely the case if you are already receiving Social Security or Rail Road Benefits. If you are not automatically enrolled in Part B, we encourage you to enroll when you first become eligible. If you wait too long, you might have to pay the Medicare Part B late enrollment penalty.

Unlike Part A, you’ll typically have to pay a Part B penalty for as long as you have Part B. Your penalty has the potential to increase up to 10% for every year you were eligible but did not sign up.

Let’s give another example. Say you were eligible for Part B for four years before you decided to sign up. In that scenario, the cost of your penalty would be 40% of your monthly premium. Medicare totals this amount to your monthly premium.

Remember: Part B is completely elective. You’re not required to enroll in Part B, but we do encourage you to enroll so you have coverage for outpatient medical services.

Medicare Part D Late Enrollment Penalty

Medicare Part D is your prescription drug coverage. Unlike Medicare Part A or Medicare Part B, you won’t be automatically enrolled in Part D; you must enroll yourself. Taking this part of Medicare is not required, but we do encourage you to enroll. The enrollment period for Part D is the same as Parts A and B, which starts three months before your 65th birthday, through the month of your 65th birthday, and three months after your 65th birthday.

For Part D, you may have to pay a penalty if you don’t enroll during your open enrollment period, and don’t already have any credible prescription drug coverage. In most cases, Medicare considers programs such as Medicare Part C (Medicare Advantage) or any other Medicare health plan that offers prescription drug coverage as credible prescription drug coverage.

Part D penalties are more complicated than those of Parts A or B. The way it works, Medicare multiplies 1% of the “national base beneficiary premium” ($33.19 in 2019) times the number of months you didn’t enroll in Part D or have coverage. This premium is rounded to the nearest 10 cents.

Let’s break it down in a real-world example. Say you don’t enroll in Part D for 20 months. If this were the case, your multiplier would be .20 (or, a 20% penalty). This number would be multiplied by the national base ($33.19 in 2019) and rounded to the nearest 10 cents. This totals to $7.00. This $7.00 penalty would be added to your monthly premium. It’s best to avoid this – try enrolling in Part D as soon as you’re able if you need to take any prescription medications.

Are There Any Exceptions to the Medicare Late Enrollment Penalties?

For Parts A and B, you may not have to pay a late enrollment penalty if you qualify for a Special Enrollment Period. You might qualify for a Special Enrollment Period if you were eligible for Medicare but didn’t enroll because you were still working. This would exempt you from penalties.

For example, if you or your spouse recently stopped working and were previously covered by your job’s insurance plan, your Special Enrollment Period begins anytime you are still covered by your job’s plan, or during an eight-month period starting the month after your employment or your coverage ends.

For Part D, you will not have to pay a late enrollment period if you qualify for Extra Help.

Is There a Late Enrollment Penalty for a Medicare Supplement Plan?

Thankfully, there are no late enrollment penalties for Medicare Supplement plans. Your enrollment period for a Medicare Supplement plan starts once you enroll in Part B and lasts for six months. While you won’t have to pay a late enrollment penalty if you miss your Medicare Supplement open enrollment period, you’ll have to undergo medical underwriting when applying for your Medicare Supplement plans.

That’s where we come in. If you are in the process of enrolling in Medicare and you’re looking to save as much money as possible by avoiding penalties, this is the perfect time to enroll in a Medicare Supplement plan. We’re here to guide you through the steps of enrollment and provide you with as much information as we can for all of your Medicare questions.

Take control of your health and don’t get stuck with a penalty or a higher Medicare Supplement premium. Let us help.

Compare Your Medicare Supplement Rates Immediately!

2 Replies to “How to Avoid the Medicare Late Enrollment Penalty”

  1. Im 67 year old and will be 68 in June of 2019 I retired on December 31, 2018 but my health insurance was through my wife employer. My wife is till working and her policy still covers us both. Am I required to sign up for Medicare now ? do I face a penalty if I don’t ?

    1. Hi Hugh,

      You are not required to start Medicare if you have credible coverage through your wife’s insurance. If you would like us to assess your personal situation more thoroughly, and go over the steps you will need to take when you are ready to get onto Medicare, you can give us a call at (800)310-2550.

Leave a Reply

Please note that once you post a comment to this website, it will be visible to the public, so be careful not to include any personal or confidential information in your comment.

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.