Its okay, Medicare Enrollment periods are confusing for most people. Be informed and be aware, missing an enrollment in medicare can cost you. Medicare should warn enrollees on steep late sign-up penalties. Roughly 750,000 Medicare beneficiaries paid late enrollment penalties in 2014, according to the Congressional Research Service (CRS). That is less than 2 percent of enrollees, but for those who do pay the penalties, the bite is painful. On average, total premiums for late enrollees were 29 percent higher, as reported by CRS.

There are also Medicare beneficiaries also lacked creditable prescription drug coverage, making them potentially liable for a premium penalty when they later do enroll in a Part D Drug Plan. Millions of people could pay monthly penalties for as long as they have Medicare coverage.

Check the links below to get a look at the different Medicare enrollment periods for 2019 and beyond that you should be aware. You don’t want to paying more than you should for the coverage you need.

Contact Us at Nevada Medicare we can help you prepare and act on time for your enrollment periods.

Your Initial Enrollment Period (IEP) for Medicare Parts A, B and D last 7 months. You should sign up for Medicare three months before reaching age 65, even if you are not ready to start receiving retirement benefits. You can also opt out of receiving cash retirement benefits now once you are in the online application. Then you can apply online for retirement benefits later.

Your Initial Enrollment Period (IEP) begins 3 months before your 65th birthday month and runs for 3 months after your birth month.

Initial Enrollment Period

During the 7-month period:

  • 3 months before the month you turn 65
  • The month you turn 65
  • 3 months after the month you turn 65
If You Join Your Coverage Begins
During one of the 3 months before you turn 65 The first day of the month you turn 65
During the month you turn 65 The first day of the month after you ask to join the plan
During one of the 3 months after you turn 65 The first day of the month after you ask to join the plan

 

As you age into Medicare, your Medicare Initial Enrollment Period is probably the most important date for you to know.

During the IEP, you can enroll in Original Medicare (Part A and Part B) or a Medicare Advantage plan (Medicare Part C). Enrolling during your IEP avoids any late enrollment penalty.

You can also avoid late penalties for Part D by enrolling drug coverage during this same window. That drug coverage can be a standalone plan or part of a Medicare Advantage plan that includes Part D.

If you enroll in Original Medicare, you may want additional coverage with a Medicare Supplement Plan (Medigap). For this, you will use your  Medicare Supplement Open Enrollment Period. This is a 6-month window starting on your Part B effective date. Using the Medicare Supplement OEP to enroll means:

  • You can’t be turned down for any Medigap plan available in your area regardless of your health status.
  • Your insurance company cannot charge you higher premiums because of your health status or pre-existing conditions.
  • Your coverage for any pre-existing conditions cannot be delayed.

There are unpleasant and costly consequences if you don’t sign up for coverage during your Initial Enrollment Period (IEP).

PART A: If you don’t meet the necessary qualifications and have to pay for Part A—the standard monthly 2019 premiums are $437 if you paid Medicare taxes for 29 quarters or less, and $240 if you paid Medicare taxes for 30 to 39 quarters—you may be assessed a 10 percent late enrollment penalty if you don’t sign up when you first become eligible.

As an example, if your premium is $437 and you waited a year to sign up, your new premium amount would be $480.70.

Base Premium ($437) X 10 Percent (.10) = Late Enrollment Penalty ($43.70)
Base Premium ($437) + Late Enrollment Penalty ($43.70) = New Premium Amount($480.70)

 

PART B: If you don’t sign up for Part B when you’re first eligible, you will be assessed a late enrollment penalty “in most cases,” according to Medicare.gov. This penalty is 10 percent for each 12-month period you were eligible for Part B benefits but did not receive them because you never enrolled.

For example, the standard premium for Part B in 2019 will be $135.50. Therefore, if you were eligible for Part B in January 2017 but didn’t sign up until January 2019, you went two full 12-month time periods without this coverage. This means that your premiums would be increased by 20 percent—a total of $162.60 per month.

Standard Premium ($135.50) X 20 Percent (.2, representing the number of 12-month periods without coverage) = Late Enrollment Penalty ($27.21)
Standard Premium ($135.50) + Late Enrollment Penalty ($27.21) = Your Premium ($162.60)
  • If don’t qualify for premium-free Part A because you don’t have enough work credits, and you don’t buy it during your IEP, you’ll pay a 10% premium penalty for twice the number of years you could have bought the coverage but didn’t.

 

  • If you don’t have creditable Part D prescription drug coverage and miss your IEP, you’ll pay a penalty with your Part D premium—again, as long as you have the coverage. The penalty is 1% per consecutive month that you went without coverage for prescription drugs. The national base premium is currently about $36 per month, so if you go without coverage for a year, you’ll pay an extra $4.30 a month (and quite possibly more if the Part D base premium increases) for as long as you have coverage.

If you are still working and have group coverage through your employer’s plan you can delay your enrollment in Part A and/or B.  When you decide to retire, you can sign up again during a Special Enrollment Period (SEP). Medicare credits you for having employer group coverage. An employer must have 20+ employees in order to be considered a large employer group.

When you retire later on, you will have a 63-day Special Enrollment Period to sign up for Parts A and/or B with no late penalties.

The month you or your spouse quits working or the month your group coverage ends Medicare Special Enrollment Period will apply. This Special Enrollment is an eight-month period.

The General Enrollment Period runs from January 1 through March 31 each year. If you missed your IEP and you don’t qualify for a special enrollment period, you can sign up for Original Medicare during the General Enrollment Period (GEP). You should know that since you missed your Initial Enrollment Period you will be subject to the late enrollment penalties at this time. General Enrollment Period only applies to Original Medicare.

Caution: If you enroll during the GEP your coverage wont become effective until July 1, this means you can go months without coverage.

There’s an Annual Enrollment Period also known as AEP, that occurs every year between October 15 and December 7. This window period is specifically for Medicare Part C – Medicare Advantage and Part D – Prescription Drug Plan. If you miss your initial Medicare enrollment period, you can use the next Annual Enrollment Period to join a plan.

During the Annual Enrollment Period you can:

  • Switch to Medicare Advantage from Original Medicare.
  • Change to a different Medicare Advantage plans if you’re currently enrolled in one.
  • Use the AEP to return to Original Medicare from a Medicare Advantage Plan.
  • Enroll in a Medicare Part D Prescription Drug Plan—or switch to a different plan if you’re currently enrolled.
  • Drop your Part D coverage completely, without penalty, if you’ve obtained creditable coverage through an employer or other source.

If you enroll in a Medicare Advantage plan and for any reason you don’t like it, you can disenroll during the new 2019 Medicare Open Enrollment Period from January 1 – March 31. Medicare gives you a window of opportunity to change your mind about your Medicare Advantage plan.

You can:

  • Return to Original Medicare and sign up for a Part D – Prescription Drug Plan
  • Switch Medicare Advantage plans once

Keep in mind that if you return to Original Medicare and plan on getting a Medicare Supplement plan you will not have a guaranteed issue rights. In many circumstances you may have to answer health questions for the Medicare Supplement plan and they do not have to accept you.

Special Enrollment Period (SEP) is a an enrollment period through out the year. This will apply you for a couple of reasons:

  • Moving outside the plan’s service area will qualify you for a Special Enrollment period. During this two-month, you can switch to a new Medicare Advantage or Part D prescription drug plan. You can also return to Original Medicare without penalty. You can sometimes also enroll in Medicare Supplement under guaranteed issue rights—with no medical underwriting.
  • Losing your Employer Group Health Coverage.
  • Losing your Medicaid Status

There may also be other circumstances that qualify you for a Special Enrollment Period. Contact Us to learn what your options are.

As soon as you are enrolled in Medicare Parts A and B, you will also qualify for a 6-month open enrollment window for Medicare Supplement plans which is the best time to buy a Medicare Supplement (Medigap) policy. This starts with your Part B effective date and is a one-time election period. During that time you can buy any Medigap policy, with no health questions asked even if you have health problems. This period automatically starts the month you’re 65 and enrolled in Medicare Part B. This period automatically starts the month you’re 65 and enrolled in Medicare Part B.

We know how important it is for you to understand the rules and regulations, as well as your rights and benefits under the Medicare Program.

Want to make sure you don’t miss any deadlines? Contact US at Nevada Medicare today! We’ll help you with when to enroll so that you can avoid any Medicare late penalties. Miss an important date, and you could pay the consequences for the rest of your life.