Toni:
I am a 67-year-old female who never enrolled in Medicare Part B or D because I believe in holistic medicine and only take vitamins. I was under the impression that if I didn’t go to the doctor, I didn’t need to apply for Medicare and could later. Now I have found a lump in my breast and know I need additional healthcare.
I went to Social Security to help me enroll in Medicare in December and was informed that I have to wait until January 1 thru March 31 of 2017 (next year) to enroll in Medicare because I missed my “window of opportunity”.
What window of opportunity did I miss? I have never received any information about this.
Thanks,
Jamie from Atlanta, GA
Jamie:
You have a big problem, but this is something that we have been seeing a lot during Medicare consultations in the Toni Says office since January 1st .
The “window of opportunity” that you missed was when you turned 65 and had a 7-month window, which is 3 months before turning 65, the month that you turned 65 and 3 months after turning 65. This special time is called your “initial enrollment period”.
Now, Jamie, you are in the “General Enrollment Period”. This is the special time for those that never enrolled in Medicare, and begins every year from January 1st and ends March 31st. Your Medicare Parts A and B will begin July 1st and your Medicare Part B penalty starts July 1st and lasts as long as you are enrolled in Medicare.
Since you are 67, you will receive a Part B penalty which is a 10% penalty for each 12-month period; yours will be 20% (2 years times 10%) since you failed to enroll. This 20% penalty will never go away and remains in effect for the life of the Medicare beneficiary’s Medicare coverage.
The 2017 Medicare Part B standard premium is $134; a beneficiary’s premium would increase by $13.40 for each full year one failed to enroll in Part B. Your penalty will be 13.40 X 2 = $26.80 monthly. This amount changes as Part B premium changes.
Currently, there are over 700,000 Medicare beneficiaries who are receiving a Medicare Part B penalty costing on average $5,000 in Medicare lifetime penalties because they did not understand Medicare enrollment periods.
Medicare enrollment periods are listed below:
- Medicare Initial Enrollment Period: Begins 3 months before turning 65, the month one turns 65 and 3 months after one turns 65. Once this special time has passed, then Part B and/or Part D penalties can begin when one enrolls later.
- Special Enrollment Period: Enroll after 65 when delaying Medicare Part B due to working full time with company benefits. This is an 8-month window of signing up for Part B without receiving a Part B penalty. “Special Enrollment Period” should be written in red on forms acquired from Social Security.
- General Enrollment Period: January 1-March 31 when one who has not previously enrolled in Part B can enroll in Medicare Part B, but WILL receive a Part B penalty.
