If your client missed the Initial Enrollment Period, the next time he or she can sign up for Part B will be during:
- Special Election Period
- General Enrollment Period
Special Election Period (January 1st – December 31st): One way to qualify for the Special Election Period is that your client (or their spouse ) must have continuous creditable coverage with a current employer. Cobra and Retirement benefits DO NOT COUNT, the client or their spouse must be receiving benefits from current employment.. This period mostly pertains to individuals who are planning to retire sometime after he or she turns 65. Those who are going to continue to work and keep their employer health benefits after they turn 65 may choose to wait to sign up for Part B until they decide to discontinue their current insurance. However, they should also contact their current insurance human resource department to see how Medicare benefits can work with employer health benefits.
For more information on the Special Election Period go to Medicare.gov or click here.
General Enrollment Period (January 1st – March 31st): If your client does not sign up for Medicare Part B during the Initial Enrollment Period and does not carry creditable health coverage with a current employer, then the client may request Part B from January 1st-March 31st, However, coverage will not begin until July 1st. Your client will also be subject to a 10% penalty to their Part B monthly premium for as long as he or she continues Part B coverage. Also, if your client continues to wait to sign up for Part B, the penalty will INCREASE by 10% for every 12 month period that they do not have coverage
Scenario 1: For Instance, Mary’s 65th birthday is on June 22, 2016. Mary forgets to sign up for Part B during her seven month Initial Enrollment Period (March 1st, 2016 – September 30th, 2016), so she must wait until January 1st, 2017 – March 31st, 2017 to sign up for Part B. Mary’s Part B monthly premium will increase by 10% and she will be uninsured until July 1st, 2017.
Scenario 2: If Mary waits until January 1st, 2018-March 31st, 2018 to sign up for Part B, then her monthly premium will increase by 10% and she will be uninsured until July 1st, 2018. (The penalty did not increase by 20% because 2 full 12 month periods did not pass since her 65th birthday. Only 19 months have passed.)
Scenario 3: If Mary waits until January 1st, 2019 – March 31st, 2019 to sign up for Part B, then her monthly premium will increase by 20% and she will be uninsured until July 1st, 2019. (The penalty increased by an extra 10% because 2 full 12 month periods have passed since her 65th birthday. A total of 31 months have passed.)
For more information on the General Enrollment Period go to Medicare.gov or click here.
For more questions on “When should I sign up for Part B?” go to Medicare.gov or click here.
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