Most people become eligible for Medicare during the months around their 65th birthday. If you don’t sign up for Medicare during this initial enrollment period, you could be charged a late enrollment penalty for as long as you have Medicare. Here’s a look at when you need to sign up for Medicare and the penalties you could be charged for late enrollment.
[See: 10 Things You Need to Know About Medicare.]
Medicare parts A and B. Individuals who are receiving Social Security benefits may be automatically enrolled in Medicare parts A and B, and coverage begins the month they turn 65. But those who haven’t claimed Social Security will need to take action to sign up for Medicare. You can first sign up for Medicare Part A hospital insurance and Medicare Part B medical insurance during the seven-month period that begins three months before the month you turn 65. Your coverage can begin as early as the first day of the month you turn 65, or the first day of the prior month if your birthday falls on the first of the month.
If you don’t enroll in Medicare during the initial enrollment period around your 65th birthday, you can sign up during the general enrollment period between Jan. 1 and March 31 each year for coverage that will begin July 1. However, you could be charged a late enrollment penalty when your benefit starts. Monthly Part B premiums increase by 10 percent for each 12-month period you delay signing up for Medicare after becoming eligible for benefits. “The idea behind the penalty is to give people a financial incentive to enroll in insurance from the get-go as opposed to waiting until they have some kind of negative health event,” says Mark Duggan, an economics professor at Stanford University.
[Read: Medicare Out-of-Pocket Costs You Should Expect to Pay.]
If you or your spouse is still working after age 65 for an employer that provides group health insurance, you need to sign up for Medicare within eight months of leaving the job or the coverage ending to avoid the penalty. “You could [sign up] at any time after you turn 65 and are actively working, or when you retire they give you eight months to sign up for Medicare Part B without having to pay a premium penalty,” says David Santana, a health insurance specialist for the Centers for Medicare and Medicaid Services. Retiree health insurance and COBRA coverage are not forms of health insurance that allow you to avoid Medicare’s late enrollment penalty.
Medicare Part D. Medicare Part D prescription drug coverage has the same initial enrollment period of the seven months around your 65th birthday as Medicare parts A and B, but the penalty is different. The late enrollment penalty is applied if you go 63 or more days without credible prescription drug coverage after becoming eligible for Medicare. The penalty is calculated by multiplying 1 percent of the “national base beneficiary premium” ($35.02 in 2018) by the number of months you didn’t have prescription drug coverage after Medicare eligibility and rounding to the nearest 10 cents. This amount is added to the Medicare Part D plan you select each year. And as the national base beneficiary premium increases, your penalty also grows.
[Read: Medicare Premiums Increase for Many Retirees in 2018.]
Medicare supplement insurance plans. Medicare supplement insurance plans can be used to pay for some of Medicare’s cost-sharing requirements and sometimes services traditional Medicare doesn’t cover. The initial enrollment period is different than the other parts of Medicare. It’s a six-month period that begins when you are 65 or older and enrolled in Medicare Part B. During this initial enrollment period, private health insurance companies are required by the government to sell retirees a plan regardless of health conditions. “That’s when you’re entitled to get a Medigap plan without substantial underwriting,” says Ronald Kahan, a medical doctor and author of “Medicare Demystified: A Physician Helps Save You Time, Money, and Frustration.”
After this enrollment period, insurance companies are allowed to use medical underwriting to decide how much to charge for the policy and can even reject patients they don’t want to cover. If you miss the initial enrollment period, you are no longer guaranteed the ability to buy a Medicare supplement insurance plan, or you could be charged significantly more if you have any health conditions. You might not be able to switch to a new supplement insurance plan later, so choose carefully during the initial enrollment period. “Once you have been on a supplemental plan for a while, and let’s say you get sick, the plan that you are on must keep you, but another plan does not have to take you,” Kahan says.
Emily Brandon is the author of “Pensionless: The 10-Step Solution for a Stress-Free Retirement.”
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Medicare Enrollment Deadlines You Shouldn’t Miss originally appeared on usnews.com
Update 03/28/18: This story was originally published on Aug. 15, 2016, and has been updated to include new information.
