Medicare penalties cost Americans millions. Here’s how to avoid them.
Dear Toni: I discovered that my mother, who is 67, never enrolled in Medicare Parts B or D. She thought if she did not go to the doctor that she did not need to pay the premium, saying that she needed the money to pay for her car and could enroll later.
She has been diagnosed with colon cancer. I called Social Security to help her enroll in Part B and was informed that she had to wait until Jan. 1. The Social Security agent said that my mother has missed her “window of opportunity,” since she did not enroll when she turned 65, and that she will receive a penalty.
What can I do to help her? — Jeanine from El Paso, Texas
Dear Jeanine: Your mother has an extremely serious Medicare issue. She will have to enroll during Medicare’s general enrollment period (Jan. 1-March 31) for those who never enrolled in Parts A and B. Your mother will receive the infamous Part B penalty for the rest of her Medicare life.
Beginning Jan. 1, 2023, Medicare’s general enrollment rules changed to help Americans who had not enrolled when turning 65. Now when you enroll in January, February or March, your Medicare Part B begins the first day of the following month. If you wait past March 31, your Medicare enrollment will be delayed until Jan. 1 of the next year, and you’ll receive a higher Part B penalty, which will go all the way back to the month you turned 65.
When your mother enrolls in Part B, she will receive the Part B penalty: 10 percent for each 12-month period that she failed to enroll. Her penalty will be 20 percent (two years times 10 percent). That penalty remains in effect for the life of the beneficiary’s Medicare coverage.
To enroll in a Medicare Part D plan, your mother must wait until the next annual enrollment period (Oct. 15-Dec. 7). Her Part D plan would then start Jan. 1.
The Medicare Part D penalty is 1 percent for each month that you failed to enroll from age 65. This penalty also changes as the average premium changes.
Medicare enrollment periods are:
■ Initial enrollment period: The seven-month window begins three months before a person turns 65 and includes their birthday month and the three months afterward.
■ Special enrollment period: The eight-month window of signing up for Part B without receiving a penalty after turning 65. One must be working full time with company benefits to avoid the penalty.
■ General enrollment period: Jan. 1-March 31 for anyone who has not enrolled in Part B. You will receive a Part B penalty if you are past your initial enrollment period and do not meet the criteria for special enrollment.
Currently, more than 7 million Americans are receiving a Part B penalty, costing an average of $5,000 over their Medicare lifetime, all because they did not enroll at the right time.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.