Health & Wellness / Your Medicare Advisor

Medicare Tip of the Week – Delayed Part B

As Americans are living longer, we are also working longer.  Many of us work past the age of 65 and continue to have group health coverage through our employers.  This may alleviate the need to enroll in part B until retirement time.

If this scenario describes you, there are differences in your enrollment periods that you should be aware of.  Your Initial Coverage Election Period changes for enrollment into an Advantage Plan (with or without prescription drugs included).  You will only be able to enroll during the three months before the start date of your part B coverage.  You may qualify for a Special Election Period based on loss of employer coverage which can include the month of your coverage loss, and the two months after.

If you are interested in a Stand-alone Prescription Drug Plan (PDP), there are also changes to your enrollment period.  You may no longer qualify for the Initial Enrollment Period; however you may qualify for the Special Enrollment Period based on the loss of employer coverage.  This period would also include the month you lose your employer coverage as well as the two months after.

If you are interested in a Supplement, you will be eligible for open enrollment, which continues for six months after your Part B start date.

Please keep in mind that the above is a general description of how a delay in your Part B coverage can affect your enrollment periods.  Each person can have a unique situation.  AMAC strongly recommends that if you have delayed your Part B, or are considering delaying your Part B for any reason, that you contact Medicare at 800-MEDICARE, or Social Security at 800-772-1213 to inquire about your exact scenario and how your delayed Part B may affect you.

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Linda Haskins
4 years 6 months ago
I will turn 65 in October. Since my husbands death in 2009, I have been without insurance, by the grace of God I have remained healthy. I do receive social security, as my husband was approved for disability 2 days prior to his death. However as many of us know that is not enough to live on, so I was able to get a part time job. My complaint is that I can only earn a certain amount or I will lose a portion of my benefits (which my husband died for). Plus, I still have social security, medicare, etc. withheld from my pay checks——not exactly fair as I will never be able to claim my own benefits. Why, because my husband died I no longer am entitled to benefits I worked for all my life. I know this began as widows benefits, but times have changed and it is… Read more »
Geraldine Dellenback
4 years 6 months ago

My husband tried NOT to take Social Security but only Medicare part B. We knew that we would be taxed on the SS benefits and with accounting, it would eat up the remaining sum. The man helping us said he nearly fell off his chair as he had NEVER had anyone NOT wanting to take Social Security! Is there something wrong with the system?

Liviu Giuroiu
4 years 6 months ago

That depends! If you have enough to live without SSB and you want to postpone it, then it’s ok. This will help you to increase your SSB (Social Security Benefits) by applying for it later. Otherwise, it really does not make sense. This are money you have paid into (plus the companies you worked for) all your life! Why in the world (except as above) you would not get your SSB?
Second, I mentioned this yesterday, you must take the Medicare Part A (it’s free!) because it pays for the hospitalization!!!

Diana Wisniewski
4 years 6 months ago
There are few absolutes in Medicare because of the tremendous amount of situations calling for exeptions. For example, people are not required to take Part A or Part B, they can have one without the other, neither or both. Your statement is correct for many people, but not for all people. Part A is only free if you (or your spouse) have worked forty quarters and paid in to Medicare. If you have not, it can have a premium as high as $451 per month for 2012. A person may have a retiree plan with very specific guidelines as to which parts of Medicare the beneficiary must take in order to have the retiree coverage in effect. This may or may not require the beneficiary to take Part A, B or both. This is why I recommend to everyone with unique situations to contact the Social Security Administration and/or their… Read more »
Phil C.
4 years 6 months ago

Is there a non-government group that helps seniors with insurance forms and red tape? My ex-wife handled all our paper work and had a knack for it. On my own I can’t even figure out how to submit a claim. I gave the dentist my UnitedHealth card (APWU consumer driven option) and they said I have to pay in full on my credit card and then apply to be recompensed. I thought all medical providers submitted bills to the ins. companies. I ended up paying out of pocket. So now I just don’t go to the dentist or doctor. I can imagine being hauled off in an ambulance and end up losing my house.

Liviu Giuroiu
4 years 6 months ago

Go to another dentist! This is just lazy or greedy!
Same for doctors. If they don’t submit to the Insurance, find another one.

MARLIN ZYGULA SR
4 years 6 months ago

I COUNT ON MY MEDICARE PART A ,B TO TAKE CARE OF ME ,WHY THEY KEEP MESSING WITH IT I DONT KNOW SOON WE WILL HAVE NO COVERAGE AT ALL

Liviu Giuroiu
4 years 6 months ago

Explain what you mean!

MARLIN ZYGULA SR
4 years 6 months ago

WHAT A JOKE OBAMAS HEALTH CARE PROGRAM IS ,I KNOW AMERICANS THAT CANT GET ANY MEDICAL HELP AT ALL ,AND THEY HAVE NO JOB ,NO MONEY ,NO CAR ,,NOW THEY NEED HELP ,NOT THE ILLEGALS

B.A. Miller
4 years 6 months ago

question: Will there be a penalty for not signing up for part D? Neither my husband nor I have taken prescription drugs until this year.

Heis 66 and just started taking one prescription drug which he will be on for the rest of his life.

Jim Ming
4 years 6 months ago

Something I forgot to mention. if there is a MA (MEDICARE ADVANTAGE plan) available in your area that your Dr. accepts usually the Part D plan comes with it with out a charge. This means that if there is a penalty it should be very small with the same drug coverage as a stand alone Part D plan.

Jim Ming
4 years 6 months ago
There is a 1% penalty for your Part D plan every month after your Initial Enrollment period ends. There are several different time frames for this. It is a Govenment imposed penalty of 1% monthly for the rest of your life from the effective date of your part D. The part D penalty amounts to about $4.20 per year or about .35 a month. I personally think this is unconstitutional and I am constantly writing appeal letters to get this waived. It has worked on occasion. I am a Medicare Broker who tries hard to stay abreast of all of the rules but they seem to change daily. My suggestion is to find someone local who write Medicare plans to discuss your options. Beware and Careful. There are a ot of insurance agents in the business for the wrong reasons. Good Luck.
Bob Lewis
4 years 6 months ago

As far as I’m concerned, they can take the entire program and shove it where the sun doesn’t shine. I’ve paid for the stupid program and will not apply for anything further or return any correspondence sent to me.

What a piece of crap! I paid a lot of money to call it what it is!!!

Liviu Giuroiu
4 years 6 months ago
For everybody: if you want to reduce your telephone expenses, buy a MagicJack Plus. You don’t need to keep the computer on all the time, and you can talk as much as you want to USA and Canada. I bought for myself, my daughter, my friends, and I initially paid $69 for the device and one year connection; you can extend the subscription for another 5 yrs. by paying $99.00. That’s all, and for the next 6 yrs. you will not pay anything else. Get rid of the landline, which is expensive and does not give too many minutes, except if you pay extra for them. You can buy online. Go to mymagicjack.com and follow the instructions. You can also buy at Wal Mart. Make sure it is MagicJackPlus, not just the old version MagicJack! That’s true that sometimes is not as perfect sound as for the landline, but you… Read more »
MARLIN ZYGULA SR
4 years 6 months ago

I AGREE WE GOT OBAMA TO THANK FOR THIS WITH HIS HEALTHCARE,ONLY ONE I KNOW WHO WILL BENIFIT IS THE ILLEGALS ,GUESS THEY MEAN MORE THEN WE DO

Alan Minthorn
4 years 6 months ago

Most of the posts paying penalties have not mentioned, nor did Diana’s article, your need to provide proof of creditable coverage at the time of the postponed enrollment. Your employers should have provided this and a copy submitted at the time of starting Part B/English . You can appeal in writing the penalty by completing an appeals form and supplying your evidence of creditable coverage to reverse the process and recover your $.

The root of the penalty, as with all things government, is based on the concept if you would have started Medicare on-time – the government would have been receiving premiums when they projected they should have. Since you delayed contribution, without proving your creditable coverage, they think you avoided your obligation and therefore impose a penalty to recover lost premiums and interest based on your projected contribution.

Bob Mutters
4 years 6 months ago
Most employers are moving in the direction of requiring their employees, active or retired, to enroll in Medicare Parts A & B when the individual turns age 65 because it reduces the employers insurance cost. The employer may, or may not, then provide supplemental insurance at a much lower cost to the employer. Employers are facing the same problems as Medicare, the exploding costs of medical care resulting from people living longer, and want to transfer this cost to the government ASAP. For those who think they should be able to wait until they need medical coverage that destroys the whole concept of insurance which is based upon the concept of spreading the risk among those who have a claim and those who do not. My wife and I paid for Medicare for 12 and 11 years with no signicant claims until last year when she needed a knee replacement… Read more »
Wendell
4 years 6 months ago

Glad to see I’m not the only one who missed the big print or fine print that said I would be penalized for not signing up for Part B when turning 65. Now this year I picked up Part B when I switched to Senior Blue and sure enough I’m paying a penalty. I have yet to have any one explain why I need prescription coverage when I don’t take any prescriptions even now at 70.

Liviu Giuroiu
4 years 6 months ago

You don’t have to take Part D, but to cover some you may want to take Medicare Advantage (Part C). Most Medicare Advantage plans cover Medicare prescription drug D. Be careful and check because each Medicare Advantage plan can charge different out-of-pocket cost and have different rules (i.e. may need a referral to see a specialist or if you have to see only doctors and facilities within their network).
Remember, since the companies who provide these types of insurance are private, rules can change every year.

Bob Lewis
4 years 6 months ago

I was given the same BS when I was told that I had to enroll in MEDISCAM, so I did that. Now, a year later, gthey give me the same garbage about MEDISCAM PART B. I have requested that my enrollment be cancelled in the entire SCAM !!

N. Colmen
4 years 6 months ago

Hey Guys. If you didn’t joint part B when it was by the very first time available to you, then it is a very ugly thing if you want to join 2 or more years later. That is, they penalize you very heavily..I am not going to pay more than $200 a month for Part B that I don’t need yet. then I will never join. Imagine if you try to join in 3 or 4 more years!! No one says nothing about it. Aren’t you guys seniors?…Complaint about it…make noise… no one protects seniors …everybody forgets they will be seniors…or they have luxurious pensions (all those Federal and State Government Retirees Politicians and big Labor Union Bosses) that then part B is not needed…

Momcat200
4 years 6 months ago

You don’t have to sign up for part B when you are first eligible. If you do sign up later, it will cost more.

Dave Podesta
4 years 6 months ago
When working I had United Health Care. I had a $5 doctor visit co-pay and $2 and $5 drug coverage co-pay. I retired at 61 yrs old. My employer told me that upon reaching 65 yrs of age I would HAVE TO sign up for Medicare Pt. B, with UHC as the secondary insurance . I didn’t want to; I was extremely happy with UHC. Now, it is my understanding that Medicare was intended to be the “universal health coverage” of the ’60’s, for people without medical insurance – much like Obamacare. I am being forced to sign up for Medicare which isn’t nearly as good as UHC. Medicare pays whatever they pay and then UHC pays 80% of the remainder with me having to pay whatever is left unpaid.The net result is that now I have much less coverage, at a much higher cost than I did before age… Read more »
Max
4 years 6 months ago

couldn’t agree more
I was covered unted my husband who was a carpenter and paid only co-payments. The doctors were paid by his union. Now I am on Medicare, at a cost of $100 per month (it was $115, but they lowered it) I have more paperwork and the doctors get less.

Thomas Lytle
4 years 6 months ago

I seem to recall hearing or reading from Social Security Administration that if you elect not to take coverage B and later change your mind, you may be required to pay all the past premiums.Also, even if you have private coverage through the employer, there is often a coordination of benefits provision in the private contract, so that Medicare and the private insurer coordinate with no duplicate or overlapping of coverage. Tom Lytle

Diana Wisniewski
4 years 6 months ago
You are correct, Medicare and the private insurer will coordinate benefits. In some cases Medicare will be the primary payor, in other cases Medicare will be the secondary payor. For each 12-month period you delay enrollment in Part B, you will have to pay an extra 10% of the Part B premium. In most cases this penalty will stay with you for as long as you have Part B. If you enroll during an SEP (special enrollment period) you may not have to pay this penalty. An example of an SEP is loss of employer coverage. You may be thinking of a delayed Part A, where you will incur a 10% penalty of the Part A premium for double the amount of time you did not have the coverage when you could have. For example if you delayed part A for two years, you will have to pay the 10%… Read more »
Liviu Giuroiu
4 years 6 months ago

For everybody’s information. Once you are 66 yrs. old and you are still working, you can collect full SSB (social security benefits) and salary without any penalty.

Don Nace
4 years 6 months ago

If you decide to start Social Security make sure you have them take out for Taxes. I believe the max is 25%. They will count it as income and you don’t want to get a big surprise at April 15th.

FlaJim
4 years 6 months ago

Nonsense. SS is not taxable.

Supplementary retirement payments may be, depending on how much they are (over $9500 in 2011 if you take the standard deduction). Those are summarized on the 1099-R you should receive in late Jan or early Feb. Don’t make the mistake of having those paid to you untaxed unless they’re a small amount. Some people think all retirement income is nontaxable and dig themselves a deep hole the first year of retirement.

BTW, I’ve prepared taxes for others for over 30 years.

Liviu Giuroiu
4 years 6 months ago

Nothing is AUTOMATIC. You MUST apply for Part A!

Marie
4 years 6 months ago

We have had great health insurance for 35 years. My husband is retired, just turned 65. Got flooded with all kinds of retirement insurance ads. Received the Medicare A card and everyone we spoke with on the phone suggested he sign-up for Medicare B, which he has done. I don’t understand why you should have to do this when you already have insurance. Can anyone explain this to me?
When you call anyone for assistance, they don’t know anything, they just keep transferring the call. Wasted 2 hours one day.
If you have good health insurance, do you really need to have Medicare B? Does anyone know? If so, please let me know.
Thanks.

Charles Haney
4 years 6 months ago

When I turned 65 they I was actually told by my company Insurance Company that I was requrired to sign up for part A and B and when I called Social Security / Medicare they told me that in as I had a good Hospitalization with the company I am working for and I am still working that I could wait and sign up later for the part B without any penality. She said that my part B might go up later due to later price increases but that was all. Who knows for sure?

Liviu Giuroiu
4 years 6 months ago
If you have a good Health Insurance, you don’t have to sign for Medicare Part B. If some day, you want to change this, and used Medicare Part B or Medicare Advantage Plus, you will NOT be penalized, but you will need proof that you have been insured by XXX company. The question you have to ask yourself is also what will happen if your spouse goes to heaven? Would you be able to keep his Health Insurance? If yes, everything is fine. If no, then if you passed 65, you will be able to sign for Part B or Medicare Advantage Plus without penalty, but with proof that you have been insured. Also, keep in mind if you need a lot of medication and if you will not have adequate coverage. You may want to go to a Social Security office and discuss your situation with them to make… Read more »
Liviu Giuroiu
4 years 6 months ago

One of the sentence at the end I did not finish it.
Here it is: Also, keep in mind if you need a lot of medication and if you not have adequate coverage from your present or former company for medication, then subscribe from the very beginning for Part D. In 2011, it was $32.34/month.

Marie
4 years 6 months ago

Thanks. You have made more sense than all the people getting paid to help.

Woody Sorensen
4 years 6 months ago

I currently have my supplemental health insurance with United Health thru AARP and wished to change to AMAC using Mutual of Omaha, however I find Mutual of Omaha would not accept me because they looked at a couple prescriptions I was given for a 3 month irregular heart condition which was corrected and was stopped last year and has been normal ever since, I have excellent BP and heart rate, my weight is normal and overall health is excellent. I am still working every day and work out regularly, however that does not seem to matter to some administrator at Mutual of Omaha so both my wife and I will continue to give our health insurance to AARP because of a very arbitrary and short sighted opinion by AMAC (Mutual of Omaha)!

Stan....S.C,
4 years 6 months ago

When you reach 65, you’re automactally covered under medicare Part A. You have the option to take Part B. If you don’t enroll then your cost will go up each yr. you don’t. I went thru the tricky part of delaying Part B, as my employer continued my coverage after retiring, then after that was phased out to take a supplement, i was penalized for delaying Part B. Although S.S. says there are options, they WILL charge you more. My advice is, go ahead and take part B went you take Part A.

Liviu Giuroiu
4 years 6 months ago

You are NOT automatically covered under Part A, but you MUST apply immediately or within 3 months after you reached 65, otherwise you will be penalized, and have to wait for next year enrollment.
To: Stan C. You should appeal the penalty by bringing the letter from your former Health Insurance that you were covered until now. If you don’t have a proof, or don’t know you need a WRITTEN proof, they will penalize you.

Stan....S.C,
4 years 6 months ago

F.Y.I. My employer was self-insurd, and the S.S. people made numerous calls to them wanting info. as i said if you Don’t take out Part B and this results, it gets to be a sticky situation. S.S. seems not to understand situations that are outside the Norm.

Stan....S.C,
4 years 6 months ago

My Response is only about Social Security Medicare. If, you’re Not qualified for S.S., then you will come under your State welfare system, which is under the Social Services System, which will provide you with Medicaid and Social Service Income (SSI).

marta jones
4 years 6 months ago

I am 69 and have medicare and United American as supplement. I have now received medicaid. should I continue paying United American or is there another option that is better..

Alan Minthorn
4 years 6 months ago

Depending on your area, there may be a Medicare Advantage Special Needs Plan covering your Dual-Eligible status. Go to the Medicare.gov website the “find plans in my area” tab and check all the appropriate check boxes. If a SNP is available, it should be listed.

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