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Missing Medicare Enrollment Windows Can Lead to Costly Late Penalties

Medicare is a massive government health insurance program that currently serves one in every six Americans. Just as with any large program, knowing the ins-and-outs of important enrollment timelines, rules and procedures can be a lot to manage. They are especially important, however, considering that even a slight oversight can lead to costly late penalties.

For example, Medicare Part B is a core component of the program. It covers medical services in conjunction with Part A hospital coverage, and extends to cover items such as X-rays, diagnostic tests, blood transfusions, chemotherapy, renal dialysis, preventive services, and more. Did you know, however, that failing to enroll in Part B during the appropriate time slots can be quite costly?

Failing to enroll can not only put seniors with no outside coverage at risk of absorbing astronomical health care costs, but a 10 percent monthly premium increase penalty can apply for each year the senior was eligible for Part B coverage, but didn’t enroll. That higher rate would apply for as long as someone had Part B once he or she finally did enroll.

Further, according to Medicare, if you miss your initial enrollment period for Medicare Part D prescription drug coverage, or a Medicare Advantage plan, (among other coverage areas), the program offers a 63-day grace period. Once that passes, late applicants are on the hook for significant penalties.

Medicare doesn’t do this to punish seniors, but the truth is that late enrollments cost the program money just as it would any private health insurer. The key to avoiding late penalties is simple, but not always easy. Medicare participants should plan to apply for their desired coverage during their initial enrollment period or during the program’s annual open enrollment period.

Initial enrollment is a seven-month period that begins three months prior to an eligible senior’s 65th birthday month. If he or she is scheduled to receive Social Security retirement benefits at 65, then enrollment in Medicare Part A and B (which is optional) is automatic. If not, manual enrollment is required.

If a senior misses the initial enrollment or would like to change existing Medicare coverage, they can do so during Medicare’s annual Open Enrollment Period, beginning October 15th and ending December 7th. Let us share with you a few ways to do this

  • Visit your local Social Security office.
  • Call Social Security at 1-800-772-1213.
  • Mail a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in Medicare.
  • Apply online at www.ssa.gov

Medicare can be confusing. Especially when you know there is a deadline to make changes. The key is to find the plan that will work for you based on your health needs. Do not wait to ask us your questions and learn more on the Medicare website, including using the Medicare tool to research plan benefits.