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Delaying Medicare Enrollment Can Result in Penalties

Medicare provides a seven-month initial enrollment period for those approaching Medicare at age 65. That’s a generous length of time, but some still miss the deadline. When that happens, there can be a penalty.

The Late Enrollment Penalty for Medicare Part B is 10% of the monthly premium in effect for that year for every full year that enrollment is delayed. In 2018, that will be $13.40. Plus, there can be a considerable delay in coverage becoming effective.If someone misses the entire Initial Enrollment Period, the next chance to enroll is during the General Enrollment Period, January 1 through March 31. Coverage then becomes effective July 1. 

Ericka Evans turned 65 in January 2016. She was out of town for a family emergency. After that, she took off on a world cruise and Medicare slipped her mind. She realized her mistake later that year. She had to wait until the General Enrollment Period in January 2017, and her Medicare coverage took effect the following July. Because she was a full two years late in enrolling, she pays an additional amount every month for Part B. In 2018, that's $26.80.  

After enrolling in Part B during the General Enrollment Period, the beneficiary can sign up for Part D drug coverage from April 1 through June 30. There's a late enrollment penalty associated with that, too. It is 1% of the standard Part D premium in effect for that year for every month the individual was without prescription drug coverage. The 2019 penalty amount if $0.332. 

Erika delayed enrollment in Part D for 31 months. In 2019, she will pay an additional $10.29 every month for prescription drug coverage. 

Both the penalties follow the beneficiary for life and the amount will change every year, depending on the standard premiums for Part B and Part D. 

Those who did not enroll in Medicare at age 65  because they had coverage through an employer group health plan have a different situation. Since age 65, if they have had continuous coverage through a group plan based on the current employment of the individual or spouse, they can qualify for a Special Enrollment Period (SEP). This is an eight-month period, beginning with the first day of the month after the end of the coverage or related employment, whichever comes first. If they do not enroll during that SEP, they, too, must wait for the General Enrollment Period.

The best advice: Don't miss your chance to enroll in Medicare. 

Last updated: 09-04-2018