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Applying Late for Medicare Part B – Here’s What You Need To Know

How Late is Too Late on My Medicare Part B Enrollment

When it comes to figuring out Original Medicare, it is important to remember that it comes in two parts:

  • Medicare Part A (hospital insurance) covers hospital stays, hospice issues and nursing care
  • Medicare Part B (medical insurance) covers medical costs, including prescriptions, doctor services, preventative services and outpatient care

More than likely, a person who is Medicare eligible due to age, will be automatically enrolled in Part A around the time that they turn 65 years old. If you are turning 65 in a few months and have not received any information in the mail yet about how to complete enrollment in Original Medicare, you should either visit your local Social Security Office or visit for more information.
If you are turning 65 years old, you can enroll in Original Medicare starting three months before you turn 65 years old. The deadline to enroll is three months after you turn 65 years old. If you put off enrolling in Part B in particular, you may have to pay a late enrollment penalty when you do decide to enroll. The penalty is calculated by adding an additional 10% to the monthly premium multiplied by each full 12-month period that the person chose not to enroll in Part B coverage. For instance, if a person chose not to get Part B coverage for three full years, their Part B premium could be increased by 30%.
If you are late, 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. A little bit of preparation today can ensure you a great deal of peace of mind tomorrow.

With Medicare, it is better to enroll sooner, rather than later

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 money for your Medicare insurance. As explained, for every 12 months that you delay in signing up for Part B coverage, the price will increase an additional 10 percent. However, when exactly those 12 months begin is something that can be very difficult to understand.
There are a number of extenuating circumstances that can affect what you need to pay and whether you have a little more or less time to enroll than other people. If a person who is eligible for Medicare due to age does not sign up during that time, which again starts three months before they turn 65 and ends three months after they turn 65, they can also sign up for Part B during the Original Medicare open enrollment period, which goes from January 1 and March 31.

Avoiding late Medicare enrollment penalties

The rule on penalties for late Part B enrollment only applies to those who waited at least an entire year to enroll. If your 65th birthday falls outside of the Original Medicare open enrollment period and you do not sign up for Part B during that initial period but do sign up during the open enrollment period (January 1st – March 31st), which is less than a full year later, you should not face a higher premium.

Medicare Part B enrollment period

We’ve already discussed the first enrollment periods for people who age in to Medicare (the three months before and after the person’s 65th birthday or during the Original Medicare Open Enrollment Period), but there are circumstances when a person can delay signing up for a Part B plan entirely.
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 policy or under your union’s policy and the second exception 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 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.

Medicare Special Enrollment Period

It is also important to remember that a Special Enrollment Period does not apply with group insurance, even for someone who is planning to continue working past 65 under two conditions:

  1. 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.
  2. The second condition is when you are covered by temporary group health insurance from COBRA.

Medicare and Medicaid – Explaining the difference

If your Medicaid becomes active when you are younger through disability, the deadline is generally the same as what has been described. But if you or your spouse is covered by a group plan, 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. The exception is if you are someone who is covered under 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. As such, 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 directly 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.