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Missed Your Medicare Initial Enrollment Period?

Sonia Ashford

Sonia Ashford

Sonia Ashford is the owner of Ashford Insurance, an independent health insurance agency specializing in Texas Medicare insurance.

If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you will have to enroll during either a Special Enrollment Period (SEP) or the General Enrollment Period (GEP) to enroll in Part B or Premium Part A unless you have limited income and savings and are eligible for a Buy In.

Missed Your Medicare Initial Enrollment Period?

If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you will have to enroll during either a Special Enrollment Period (SEP) or the General Enrollment Period (GEP) to enroll in Part B or Premium Part A unless you have limited income and savings and are eligible for a Buy-In. If you are eligible for Premium-Free Part A, you can enroll at any time.

 Special Enrollment Period

If you are eligible for the Part B SEP, you can enroll in Medicare without penalty at any time while you have job-based insurance and for eight months after you lose your job-based insurance or you (or your spouse) stop working, whichever comes first.

If you are under 65, are Medicare-eligible due to disability, and have job-based insurance through a family member’s current work, you may also be entitled to the SEP if there are at least 100 employees at your family member’s place of work.

 General Enrollment Period

The GEP takes place from January 1 through March 31 of each year. During this period, you can enroll in Medicare Part B or Part A if you have to pay a premium for it.

Enrolling during the GEP in 2022 means your coverage will start on July 1, 2022. Until that time, you will not be covered by Part B, although your Part A may start sooner if you qualify for premium-free Part A.

You might have to pay a Part B premium penalty depending on the amount of time between your IEP and your enrollment.

The Part B premium penalty.

For each 12-month period you delay Medicare Part B enrollment, you will have to pay a 10% Part B premium penalty (unless you are eligible for a SEP through job-based insurance or are eligible for a Medicare Savings Program). In most cases, you will have to pay that penalty every month for as long as you have Medicare. If you are enrolled in Medicare because of a disability and currently pay premium penalties once you turn 65 you will no longer have to pay that premium penalty.

 If you have limited income and savings, you may be eligible for additional help. the Medicare Savings Program (MSP) or Buy-in Program. MSPs help pay your Medicare Part B premium costs and may also pay Medicare cost-sharing and Part A premiums. Additional benefits of enrolling in an MSP include:

  • Allowing you to enroll in Medicare Part B outside of usual enrollment periods (like the GEP)
  • Eliminating your Part B late enrollment penalty if you have one
  • Allowing you to enroll in Premium Part A outside of usual enrollment periods in some circumstances

If you have missed your IEP but have limited income and assets and qualify for an MSP, you will be able to enroll in Part B at any time without incurring a late enrollment penalty. I recommend contacting your State Health Insurance Assistance Program (SHIP) to check if you qualify for an MSP in your state.

 I hope this helps you learn what to expect as you must enroll in Medicare late. Good luck!

 

Photo by Karolina Grabowska

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Sonia Ashford

Sonia Ashford

Sonia Ashford, “The Medicare Insurance Lady”, has been helping Medicare eligibles in Texas with their Medicare Insurance since 2005.