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What Happens if I Apply Late for Medicare Part B?

How Late is Too Late on My Medicare Part B Enrollment

When it comes to figuring out Medicare, it is important to remember that it comes in two parts. Part A covers hospital stays, hospice issues and nursing care, while Part B covers medical costs, including prescriptions, doctor services, preventative services and outpatient care. Both parts are quite important, but depending on your financial situation, it is often a good idea to look at them as two different parts that make up a whole.

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However, when this happens, it is very easy to let one slide, or to prioritize one part over another. If you have put off signing up for Part B, what are your options? The truth is that you have more options in front of you than you think, so consider what can be done at this point. It is up to you to make the most of your medical care, and a little bit of preparation today can ensure you a great deal of ease and peace of mind tomorrow.

It is important to understand what people mean when they are talking about the medicare enrollment penalty clock. Essentially, it tells you how much time you have before you need to start paying extra for your Medicare insurance permanently, for as long as you have it. For every twelve months that you delay, the price of your Part B insurance goes up 10 percent. However, when exactly that twelve months begins, that is something that can be very difficult to understand, and there are a number of extenuating circumstances that can affect what you need to pay and whether you have a little more or a little less time than normal. The initial enrollment period occurs begins after you sign up for Medicare, and there is also a period between January 1 and March 31 when you can sign up for Part B as well. This period is known as the general medicare enrollment period.  It is important that you are aware of these different periods and what they can mean for you.

First, be aware of what the rules actually are and make sure that you obtain information from a reliable source. Take a look at your policy and find out when the deadline for enrolling in Part B is. Usually, you will see a timeframe and an end date. After the end date, the law states that there will be a 10 percent penalty imposed for every 12 month period that you delay paying your Part B after your are eligible to do so. The only exception is if you also have group health coverage or if you are also on your spouse’s coverage, whether that is personal or through an employer.

However, when you look at the wording, you can breathe a sign of releif. That 10 percent penalty only applies a full year after your enrollment period expires. If it is any sooner than that you are fine.

According to the officials at the Social Security office, eligibility period begins the month after your initial enrollment period and ends on the last day of the general enrollment period for that year. If you can remember this, there is a chance that it is not too late to sign up for Part B without a penalty after all.

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It is important to make sure that you know how the late penalties do work so that you can avoid issues with this program in the future. If your initial enrollment period expires in April, and then the next January you sign up for Part B during the general enrollment period, you are still within the date to avoid a penalty, but you also only have about nine months in which to get everything done. Be aware that the 12 month time frame is a little strange in this regard.

If you have missed signing up for your Part B coverage during your initial enrollment period, you need to enroll during the general enrollment period, which runs from January 1 to March 31 from every year. Coverage does not begin for this coverage until the first day of July. If you miss this window, you are going to need pay the extra 10 percent late penalty and wait until the next year. As you can see, it is far better to simply pay your Part B coverage during your initial enrollment period for a number of reasons.

Remember that these numbers add up. Some people may choose to delay payment by as many as five years, and in in that time, it can result in a 50 percent penalty. This means that you will permanently be paying half again as much money for the same type of coverage. There are many rules to remember, but at the end fo the day, it all boils down to the fact that the sooner you pay off this coverage, the better!

However, if you are having trouble making the payment or you have missed the deadline for other reasons, it is worth looking into some of the extenuating circumstances.

For example, in a case where you are 65 and not covered by your employer’s insurance or your spouse’s insurance, your deadline comes at the end of the initial enrollment period, which expires at the end of the third month following the month in which you turned 65. For example, say that you turn 65 on February 21. The third month after this date would be May, so the last day you could sign up without a penalty would be May 31st.

If you need to delay your entry into the Plan B program after you turn 65, there are two exceptions. The first is if you are still working and you are covered under your employer’s umbrella policy or under your union’s policy, and the second is if you are covered under a working spouse’s group insurance.

Once this insurance disappears or is lost, there will be a special eight month enrollment period that allows you to sign up for Part B without a penalty. However, if you are do not sign up for Plan B at this point, the enrollment resets to the point when your insurance ended or when you retired. You do not reset to the point when the eight month special enrollment period ended.

It is also important to remember that a special enrollment period does not apply even with group insurance for someone who is planning to continue working past 65 under two conditions. The first condition is that your health insurance plan provider becomes secondary to Medicare when you turn 65. This is very common for small businesses, especially ones that have less than 20 workers. The second condition is when you are covered by temporary group health insurance from COBRA, and the third condition is if you were covered by a domestic partner of the same sex as you. In these cases, the penalty is incurred beginning in the month after the initial enrollment period expires.

To reiterate, if you have health insurance for yourself and you are working after the age of 65, you will incur penalties the month after your initial enrollment period expires. There is no special enrollment period for people under individual coverage if they dealy in signing up for Part B.

If your Medicaid becomes active when you are younger through disability, the deadline is generally the same as what has been described, though if you are covered by a group plan or your spouse is, you may need to enroll automatically in Part B if your employer keeps 100 employees or more. However, in this case, the clock resets again once you turn 65, something that puts you on the same footing as everyone else.

For people living outside of the United States, the countdown to the penalties beginning starts at the end of the initial enrollment period. This is true even when you cannot use Medicare services overseas, so be aware of this fact.

If you are someone who is confused about what penalties you might be incurring, it is important to find out what is going on as soon as possible. The longer you delay, the more you will end up paying, unless you are someone who is covered under gaining Medicare when you are younger than 65 and your penalty clock has reset. In general, it cannot be restated enough that the sooner you apply for Part B, the better. This is an essential part of your Medicare program, and it is something that you cannot afford to put off, either financially or for your own health. When you are confused about what to pay and when, make sure that you contact the Medicare offices themselves and get a straight answer. It takes a long time, and it can be frustrating, but in the end, it is worth it.

The more you know about Medicare and the more you understand what is being paid and why, the more control you will have over your health and your choices. This is an essential part of looking out for yourself and your own best interests as you age.


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