Know When to Enroll in Medicare! To B or not to B in Part B?

October 3, 2016

Authored by Joe Baker, President, Medicare Rights Center

More and more Americans are still working at age 65 but many are unaware that they are not automatically enrolled in Medicare Part B when they become eligible. Many people mismanage Medicare enrollment in part because people who are not taking Social Security retirement benefits do not receive notification about how and when to enroll. But delaying Medicare enrollment after age 65 without fully considering your situation can have significant financial consequences.

Making a careful decision about Medicare enrollment is particularly critical for Medicare Part B, medical insurance that helps pay for important services such as doctors’ appointments, preventive care, and laboratory tests. Unlike Medicare Part A, hospital insurance which is premium-free for most people, there is a monthly premium for Part B.

Delaying enrollment in Part B to avoid paying the premium can be risky. You may risk:

–going without needed health coverage;

–paying a lifetime 10 percent premium penalty for each 12-month period you were not enrolled; and

–having to wait until the annual General Enrollment Period (GEP) to enroll.

Delaying Part B might be a good choice for people who have access to a Special Enrollment Period, which allows you to enroll in Part B without waiting until the GEP and without penalty. To be eligible, you must have coverage from your or your spouse’s current employment from the time you become eligible for Medicare. The Special Enrollment Period lasts while you, or your spouse, are still working and for up to eight months after the job or insurance ends, whichever is first. Note that COBRA and retiree insurance are not considered current employer insurance.

Even if you have access to a Special Enrollment Period, you should still consider whether to enroll in Part B to avoid having inadequate coverage. Whether you should sign up depends on whether Medicare or your employer health coverage is the primary insurance.

If you are eligible for Medicare because you are 65 or over and your insurance is from your, or your spouse’s, job at a company with:

–20 or more employees, your employer coverage will be the primary payer.

–less than 20 employees, Medicare is primary. You should not delay enrolling in Part B because you will have no primary insurance – equivalent to not having insurance at all.

To enroll in Medicare, call Social Security Administration at 800-772-1213. If you are thinking about turning down Part B, call Social Security and ask if you can defer enrollment without penalty.

Recently introduced legislation in Congress would improve information for people approaching Medicare eligibility and otherwise modernize this complicated Medicare enrollment process.The Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act would require Medicare to send a notice to all people approaching Medicare eligibility that would explain Part B eligibility, the late enrollment penalty, and how any other coverage coordinates with Medicare.

Tell your member of Congress to co-sponsor the BENES Act to help the 10,000 people aging into Medicare each day avoid costly enrollment mistakes. Take action today!

Print Friendly, PDF & Email