Sometimes enrolling in Part B when you enroll in Part A doesn’t make sense, or just isn’t the thing to do.
In example, if you have group coverage, are 65 and Medicare eligible, but your spouse is not, your spouse will not be covered by your Medicare. Your spouse will have no insurance unless they have their own private or group coverage.
Be sure to speak with your union or employee benefits coordinator to find out how Medicare works with your group plan if this is the case for you before you enroll in Medicare.
This goes for federal, state, and active-duty military personnel as well. It might be to your advantage to delay your Plan B enrollment.
Once you know this information, it’s time to understand Medicare Enrollment Periods.
There Are Three Medicare Enrollment Periods:
- Initial Enrollment
- Special Enrollment
- General Enrollment
What Happens If I Don’t Enroll In Medicare Part B At Initial Enrollment
If you find you need to keep your employer group coverage, and that coverage is “credible coverage” in terms of Medicare, then delaying your Part B enrollment has no penalty.
In most cases, however, if you don’t enroll when during your initial enrollment period, your coverage will be delayed and you will pay a penalty for as long as you have Medicare Part B.
What Are The Late Enrollment Penalties?
Part A: Your monthly premium may go up, up to 10%. You will pay this penalty for twice the number of years you could have had Part A but didn’t sign up.
Part B: Your monthly premium may go up 10% for each full 12-month period that you could have had Part B but did not sign up. You will pay this penalty for as long as you have Medicare.
When Is Medicare Initial Enrollment?
Initial enrollment is the 7-month period including the 3-months before your 65th birthday month, your 65th birthday month, and the 3-months after your 65th birthday month.
If you enroll during the first 3-months of your initial enrollment period your coverage begins the first day of your 65th birthday month in most cases. If your birthday is the first of the month, your coverage will begin the first day of the month prior to your 65th birthday month.
If you enroll during your 65th birthday month or during the 3-months after your 65th birthday month, your coverage will be delayed.
What Is Special Enrollment?
Outside of your initial enrollment period you may be eligible to enroll in Part B (or Part A if you have to buy it) with no penalty.
There is no penalty if:
- You enroll while you are still enrolled in a group health plan (Credible coverage)
- During the 8-month period beginning with the month after employment or group coverage ends, whichever happens first (Credible coverage)
- You are enrolling because of End Stage Renal Disease and you meet the work requirements under Social Security or are getting or eligible for Social Security or Railroad Retirement Benefits
- You are enrolling because of End Stage Renal Disease and are the spouse or dependent child of a person meeting work requirements under Social Security
What is General Enrollment?
If you didn’t sigh up for Part A (when you have to buy it) or Part B during your initial enrollment, you can sign up during general enrollment.
When you enroll in Medicare during General enrollment, your coverage will not start until July 1 of that year, and you may have to pay penalties.
Other Medicare Enrollment Considerations
If you have TriCare you generally must enroll in Medicare Part A and Part B when you first become eligible to keep your TriCare benefits.
Health Insurance Market Place
If you have insurance through the Health Insurance Market Place, you may want to end that coverage and enroll in Medicare during your initial enrollment period.
Once your considered eligible for Medicare Part A, you are no longer eligible for help paying your Marketplace plan premiums. Check HealthCare.gov for more information.
If you have Veterans Administration Health Benefits, generally you want to keep those and enroll in Medicare Part A and Part B. Click here for more info about VA and other insurance.If you have Veterans Administration Health Benefits, generally you want to keep those and enroll in Medicare Part A and Part B. Click here for more info about VA and other insurance.