Eligibility for Medicare coverage starts at age 65. Expect your red, white, and blue Medicare card to be mailed three months before your 65th birthday. This will be mailed with instructions to enroll. Others who qualify for Medicare include those with chronic conditions. There are several Medicare Enrollment periods that requires your attention.
You are expected to enroll for Medicare during Initial Enrollment, which begins three months before the month of your 65th birthday. Enrollment extends three months after your birthday month, for a total of seven months.
People who are still getting health coverage through their employer can use a Special Enrollment Period. The Special Enrollment Period lasts eight months and starts the month after employment or the employee health coverage ends.
Late Enrollment Penalties
If you don’t enroll during your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period from January 1 to March 31. However, you will have to pay a late enrollment penalty.
For Part A, the late enrollment penalty will add 10% to your monthly premium. The higher premium will last for twice the number of years that you failed to enroll. Many people qualify for premium-free Part A, so this may not apply.
If you buy Part B, the late enrollment penalty adds 10% of the standard premium rate for each 12-month period you went without signing up. This lasts as long as you hold Part B coverage. The standard premium rate is $170.10
If you don’t buy Part D when you initially enroll, you may have to pay a late enrollment fee when you later decide to get Part D. While you have creditable coverage, you do not have to have Part D. If you don’t have creditable coverage for 63 or more days before you enroll in Part D, you may have to pay a late enrollment fee.
If you choose not to enroll in Medicare Advantage Plans (Part C) or Medicare Part D, you will not have to pay a late penalty toward either.
Medicare Open Enrollment
If you are new to Medicare then it’s important to know that Open Enrollment occurring in the Fall is only designated for changes to be made to current coverage. These changes include:
• Changing from regular Medicare coverage to Medicare Advantage regardless of having part D (or vice versa)
• Being able to join a new plan for Medicare Advantage as well as a separate Part D prescription plan
If you are still uncertain about the whole process, we’ve listed helpful tips that could help you.
1. The time-frame for Fall Open Enrollment Begins on October 15 and ends on December 7
• All open enrollment changes made become effective on January 1.
• You can switch between Medicare Advantage and regular Medicare as well as enroll in Part D coverage.
• A Medicare Supplement policy may be available where you live and helps to offset the cost of your original Medicare. There are limitations though so it’s best to check it out first.
2. Conduct a Thorough Review of Current Drug and Medicare Health Coverage Costs
• You should review next year’s costs for your Medicare and benefits located in your handbook (Medicare & You).
• Review your Medicare Advantage and Part D plan’s Annual Notice of Change as well as your Evidence of Coverage. Be aware of any change in rules, benefits, or costs that may occur during the New Year too.
• Regardless of being currently satisfied with your coverage, you should take a glance at the many other options that are available.
3. Help Is Always Available
• You have access to the plan finder tool so you can locate the best Part D plan. This tool helps by comparing the available plans that are determined by what drugs are needed, the cost of the drugs, and which pharmacy is used.
• Make sure that you confirm your new plan’s details before you actually enroll. You can change your Medicare Advantage Plan during its Open Enrollment if you are dissatisfied with your current plan
4. The open enrollment period for Medicare Advantage happens yearly between January 1 and March 31.
• Any changes made become effective the month following enrollment. At this time, you are permitted to switch your Medicare Advantage Plans for a regular Medicare plan or vice-versa.
• You can also make the switch regardless of having Medicare Part D.
5. Have a Clear Understanding of What Open Enrollment and Fall Open Enrollment is when it comes to the Federal or State Marketplace
• The State or Federal level Marketplace is also referred to as an Exchange. It offers open enrollment annually for all Americans who are underinsured or uninsured.
• Overlap may occur between it and Fall Open Enrollment. Marketplaces are not normally used by individuals eligible for or with Medicare.
So remember, if you are a current Medicare user or have recently become eligible, the Fall Open Enrollment runs from October 15 to December 7 for you to be able to make any necessary changes to your coverage.
Late Enrollment Penalty
Medicare beneficiaries pay penalties for late Medicare enrollment. These late enrollment penalties were introduced to deter people from enrolling late in Medicare. If you experience a terrible health event or a change in a medical condition but aren’t covered by Medicare, you’ll not have health insurance to help you pay for these costs.
For this reason, you are required to enroll for Medicare at specific times. Medicare penalties vary based on the part of Medicare for which you enroll late and the length of time you didn’t have coverage. The penalty fees you pay for each part of Medicare include:
Medicare Part A
If you or your spouse worked for ten years, or forty quarters, paying Medicare taxes, you’d receive Medicare Part A without paying a monthly premium. However, if you are not automatically enrolled in this plan, you will have to pay the premium. If you register for Part A after your Initial Enrollment Period (IEP), you may have to pay a late Medicare enrollment penalty.
As for the late enrollment penalty for Medicare Part A, your premium will be increased for a period of twice the amount of time you went without Part A while you were eligible. For instance, if you delay your Part A enrollment for a whole year, your penalties will last for two years.
Medicare Part B Penalty
If you are not automatically enrolled in Part B and don’t sign up when you are first eligible, you can be subject to a late penalty. You will have to pay the penalty for as long as you have the plan. The late enrollment penalty could go up to 10% for every 12-month period you were eligible for the plan but didn’t sign up. For instance, if you waited for two years before enrolling in the Medicare Part B plan, you’ll be required to pay 20% of your premium.
Medicare Part D Penalty
The late enrollment penalty for Medicare Part D is 1% of the members’ average monthly premium, multiplied by the number of late months you didn’t sign up. The Part D penalty starts if the beneficiary didn’t enroll within the first three months their Original Medicare plan becomes active. It is important to keep in mind that this penalty is permanent.
Consult with experienced and reputable Medicare insurance experts like Turning 65 Solutions to ensure you sign up for Medicare when you are supposed to and reduce penalty risks.