Medicare Enrollment Periods and Penalties for Late Enrollment
Turning 65 – Initial Enrollment Period:
Most people become eligible during the months surrounding their 65th birthday. This can be done during the seven (7) month period that begins three months before the month of turning 65 and continues for 3 months after turning 65. The coverage would begin as early as the first day of the month you turn 65. The coverage will not start prior to your birthday month. Your Part B start date will depend on the month you enrolled in Part B. Your Part D coverage will also depend on when you enroll.
Annual Election Period – Open Enrollment Period:
Starts October 15th and ends on December 7th each year
- Individuals with Part A & B can switch to a Medicare Advantage Plan (Part C)
- Individuals with Part C can switch back to Parts A & B
- Individuals who have Medicare A & B can join, drop or switch a Part D plan
- Individuals with Part C are able to switch to another Part C Plan
Special Enrollment Period:
In certain circumstances there are times when an individual can delay their enrollment in Medicare A , B, C & D. When an individual’s healthcare coverage with their employer, spouse’s employer or union group ends, this will allow an individual to sign up for Part C & D. This period is during the 60 days after the loss of their employer healthcare coverage.
Other special enrollment times are:
- Moving out of the area your current plan serves
- Enter or leaving a nursing home
- Your current plan changes and no longer serves your area
- You get Extra Help with your Medicare prescription drug costs
Late Enrollment for Medicare Part B and Penalties associated:
The monthly Part B premium will go up 10% for each full 12-month period that you could have had Medicare Part B but did not take it. This premium will be applied as long as you have Medicare Part B. Here is an
example: if you waited two (2) years to sign up, your penalty could be 20% of the premium. You would pay the Part B monthly premium plus 20% for each month as long as you have Part B.
Late Enrollment for Medicare Part D and Penalties associated:
The penalty (fee) is 1% of the average monthly prescription drug premium times the number of months you delayed enrollment. This penalty will be in place for as long as you have Part D coverage. Here is an example: if a client is 70 years old and has never enrolled in their Part D, Medicare will charge him 1% of the average monthly premium (in 2018, that premium is $ 35.02) for each month he didn’t have Part D, and that will be
added to his normal monthly payment. For him, a charge of $0.35 for 60 months, or $21.00, is added to his normal monthly premium.
This is not a comprehensive list, to find out more…