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by Stacy Calloway, Medicare Expert (UnitedHealthcare Medicare Solutions)
Confused by all the Medicare rules? You’re not alone. And if you have a question, chances are others have the same one. Our Medicare expert is available to address your concerns (Email your questions anonymously to us; please title your email 50PLUSTODAY).
Today’s column focuses on the importance of Medicare Part B Enrollment periods
What is Medicare Part B?
Medicare Part B covers the outpatient diagnosis, treatment, and prevention of medical conditions. This includes emergency room visits and preventive healthcare services like doctor’s visits, screening and diagnostic tests, and some vaccinations.
When do I need to sign up for Medicare Part B?
Good question. The short answer is you sign up for Part B during your Initial Enrollment period. It’s important to know the exact time frame for sign up. Enrollment begins three months before your 65th birth month, includes your birth month, and then extends three months after that. Most of the time, that is. If your birthday falls on the first of the month, your Initial Enrollment period begins and ends one month earlier. The bottom line is you have seven months total to complete the enrollment process.
Are there other times that I can enroll in Medicare Part B?
Yes, every year Medicare has a General Enrollment period, January 1st through March 31st. It’s Ok to enroll during this period, but you need to know your coverage does not start until on July 1st. Finding yourself without insurance for a few months is a big deal if you have health problems during that time. I have a client who missed her Initial Enrollment period, so she signed up the following year during the General Enrollment period. Unfortunately, necessary medical treatment she required was therefore not covered until Medicare went into effect in July. It’s a good idea to enroll during your Initial Enrollment period whenever possible to avoid this type of gap.
Does Medicare allow me to enroll in Part B if I have special circumstances?
You may qualify for a Special Enrollment period (SEP) to sign up for Part B if you have certain medical conditions or qualify on the basis of a disability. This period is during any month you have coverage through an employer group health plan and you or your spouse remains employed. You also have an eight month period to enroll starting with the month after your group health plan ends or the employment ends, whichever comes first.
What happens if I decide not to enroll in Medicare Part B?
Here’s the deal. In most cases, if you don’t sign up for Part B when you’re first eligible, you have to pay a late enrollment penalty for as long as you have Part B. In addition, for each 12 month period you were eligible for Part B but did not enroll, your monthly premium goes up by 10% of the standard premium. You may also face a gap in medical coverage.
There are exceptions, however. If you are under an employer plan at a company where there are 20 or more employees, you can opt to delay Part B without a late enrollment penalty. Keep in mind though, if there are less than 20 employees, you will need to enroll in Part B when you are eligible.
The takeaway
Stay on top of the deadlines, especially for Medicare Part B. Otherwise, in most cases, you’ll have to pay the penalty each and every time you pay your premiums moving forward. And the penalty increases the longer you go without Part B coverage. The good news? You can avoid these penalties, so why not make sure you do?
If you have any questions that you would like answered in this column, submit your questions to stacycalloway843@gmail.com and title your email 50plusToday, or if you would like a consultation, please visit my website at www.myagentStacyCalloway.com.
About the author
Stacy Calloway is an experienced Insurance Agent licensed in the state of Texas and currently contracted with UnitedHealthcare Medicare Solutions. Stacy educates Medicare beneficiaries on the different parts of Medicare, prescription drug plans and the benefits of becoming a Medicare Advantage or Medicare Supplement member with UnitedHealthcare. Visit Stacy’s website to learn more and follow her on Facebook!
