Category: Part B

Railroad Medicare

Railroad Medicare

Railroad Medicare – What You Need to Know

Here is what you need to know about Railroad Medicare Benefits to be successful in your retirement planning.

Introduction to Railroad Medicare

Railroad Medicare Benefits and Choices at MedicareLifeHealth.com

So, you are retiring from the Railroad? Congratulations! Mostly, your options for Medicare planning will be the same as everyone else’s. Our articles on Medicare Basics, Medicare Supplements and Medicare Advantage will all apply to you.

However, there are just a few differences between Social Security and the Railroad when it comes to Medicare. Let’s look at what these similarities and differences are.

What is the Same

Signing-up

  • Already Retired: Signing-up for Medicare is the same on SS or RRB. If you are already receiving benefits from Social Security or the Railroad you will be automatically enrolled in Medicare Part A and Part B. You can then decline Part B if you want to. (Read about declining Part B here.)
  • Not Yet Retired or Not Receiving Benefits: For those of you that are not already retired and/or not yet receiving benefits, you will need to notify the local Railroad Board (RRB) office before you turn 65 that you would like to sign-up for Medicare. You can sign-up up to 3 months before you turn 65, and even if you are not planning on retiring at 65.

Your Medicare Path Choices

Just like Social Security Medicare, you will have two options for setting up your Medicare:

  • Original Medicare: You have the option of choosing to keep Original Medicare and then enrolling in a stand-alone Part D Drug Plan. In addition, you can then add a Medicare Supplement (Medigap) plan to pick up the costs Original Medicare does not cover. You can read more about Original Medicare here.
  • Medicare Advantage: You also have the option of moving to a “bundled” Medicare Advantage plan. These plans are run by private insurance companies and bundle together Parts A, B & D all into one plan with one point of contact. They are also called Medicare Part C. You can read more about Medicare Advantage here.

You can read about the difference between Original Medicare and Medicare Advantage here.

What is Different

Part B Claims Processing

The major difference in Medicare for Railroad Board vs Social Security, is how the Part B claims are handled. Unless you are enrolled in a Medicare Advantage Plan (where the private insurance company you use handles all of your Medicare claims), you will deal with a different claims handling entity than those enrolled in SS Medicare.

The Railroad Medicare program uses an outside company for medical insurance claims that fall under Part B services. (Read more about the different parts of Medicare and what they cover here.) This company Palmetto GBA. They are a subsidiary of Blue Cross and Blue Shield. You will need to submit claims directly to them if you are under Original Medicare through the RRB.

How to Contact Palmetto GBA for RRB Original Medicare Beneficaries

If you need to submit a claim for a Part B service or ask a question, you can contact Palmetto GBA here:

Palmetto GBA
Railroad Medicare Part B Office
P.O. Box 10066
Augusta, GA 30999-0001

Toll Free: 1-800-833-4455
TTY/TDD: 1-877-566-3572
Website: www.palmettogba.com/medicare
According to the RRB website, you will click on “RRB Specialty MAC Beneficiaries” on the website above

More Information

For more information about Railroad Medicare Benefits, you can visit their website here.

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Medicare and You 2020

Medicare and You 2020

Medicare and You 2020 Guidebook – Read This First

Your Introduction to the Medicare and You 2020 Book, and where to get a copy.

The Medicare and You 2020 Guidebook details what you need to know about Medicare benefits for the current year. In it you will find the basics of Medicare, how to get it, and what changes the program is implementing in the calendar year.

However, it is 120 pages long and very detailed. It is also very dry and technical.

So, if you are trying to learn more about Medicare – without falling asleep in the process – we have on-topic website article suggestions for you here that follow the elements of the Medicare and You 2020 Guide.

Where to find the guide

What is included in the Medicare and You 2020 Guidebook?

Here we will outline the sections of the guidebook and give you relevant articles that discuss the various Medicare elements and benefits.

What are the Parts of Medicare?

Intro Section (page 5)

The Medicare and You book starts out with summarizing parts A, B, and D and what they include.

Medicare Part C is discussed in the next section.

Related Article: For an illustrated overview of the four parts of Medicare, visit our medicare parts infographic and article “Medicare Parts A B C D.”

What are my Medicare options?

Intro Section on Original vs Medicare Advantage (pages 6-8)

how to read Medicare and You 2020 guidebook

Many online comparisons are between Medicare Supplements and Medicare Advantage plans as those are the additions that are in your hands to choose.

However, all these comparisons are in their simplest form between having Original Medicare vs Medicare Advantage. This section does a side-by-side comparison of the two (with or without a supplement).

Related Article: For a more in-depth discussion to help you decide what Medicare options are right for you, please read the “Medicare Advantage vs Medicare Supplements” article here.

How do I get Medicare?

“Section 1: Signing up for Medicare” (pages 15-24)

People get Medicare in different ways. Some are signed-up for it automatically if you are already receiving Social Security or Railroad Retirement. Some people must sign up for it when they turn 65 (or delay it if they are not ready at 65).

This section gives you people to call (Social Security at 1-800-772-1213) and places to visit (online at ssa.gov/benefits/medicare) if you need to sign yourself up.

Other topics covered include, when to sign-up, what to sign-up for, and what does each part cost?

Related Articles:

Hey, Medicare and You 2020, Will Medicare Cover My…?

“Section 2: Find out if Medicare covers your test, service or item” (pages 25-50)

This section lists all Medicare Benefits you will receive if you are signed-up for both Medicare Parts A and B. These benefits are universal, meaning they are the standards of care you will receive whether you are receiving Medicare from the federal government or through a private carrier with a Medicare Advantage Plan.

If you are looking to see if a specific benefit is included in Medicare, this is the section to search for it.

This section also reminds you of what is not included in Medicare, such as Long-Term Care insurance. In addition, Original Medicare does NOT include many services that ARE covered by Medicare Advantage Plans. These include dental care, eye exams, hearing benefits, and fitness programs.

2020 New Offering Alert: One interesting change noted in the Medicare and You 2020 book is that many Medicare Advantage programs are now offering “telehealth” benefits where you can see a provider at home instead of at their facility. The guidebook notes that this is typically beyond what Original Medicare can offer.

Related Article: To see the basics of what Medicare Covers, please see our article “Medicare Parts A B C D.”

What exactly is Original Medicare?

“Section 3: Original Medicare” (pages 51-54)

The Original Medicare section explains how our Federal Health Insurance for Seniors works. If you have Original Medicare, with or without a supplement, you are a beneficiary of a nationalized health care system and the government is the primary payer of your health benefits.

Read this section to learn how that works and how to use your benefits once you are on Medicare.

Related Article: Read “What is Medicare?

What is Medicare Advantage?

“Section 4: Medicare Advantage Plans & other options”

The other option than being on Original Medicare is to be on a Medicare Advantage Plan. In this case, a private insurance company becomes your primary payer and main contact. Medicare Advantage (MA/MAPD) Plans are called “bundled plans” because they combine parts A, B and D to form one “Plan C.”

They often have reduced costs for premium payments, with some of them even offering “$0” monthly premiums. In addition, they often include extra benefits, not included by government Medicare, such as dental, hearing and eye care. “Silver Sneakers” and similar fitness/wellness programs are also often an included benefit.

Related Articles:

What is a Medicare Supplement / Medigap Plan?

“Section 5: Medicare Supplement Insurance (Medigap) policies” (pages 69-72)

Medigap Policy Chart
CLICK HERE to see more about the various Medigap plans and what they offer.

When you opt for keeping Original Medicare (instead of a Medicare Advantage Plan) you will most likely want to pair that with not just a stand-alone drug plan, but also with a Medigap Plan. These plans are also called Medicare Supplement Plans.

They are supplemental insurance plans that pick up paying where Original Medicare leaves off – such as with the 20% coinsurance, co-pays and deductibles.

The government sets the requirements for each supplement plan and then the private insurance companies decide what price they can offer for each plan in each market they are in. These plans are labeled with letters, and offer the exact same benefits no matter what private insurance company you choose.

Related Article: For more information, please read this article on Medicare Supplement Insurance.

What is Part D?

“Section 6: Medicare Prescription Drug Coverage (Part D)” (pages 73-82)

Read this section to learn how Medicare Drug Plans work, where to get one, and when you can get one / switch them.

Remember, that if you opt for a Medicare Advantage Plan, you will most likely have your drug plan included (which is called a MAPD plan).

Related Articles:

Can I get help paying for medical costs?

“Section 7: Get help paying your health & prescription drug costs” (pages 83-88)

The government has set up several ways for Medicare Beneficiaries to get help in paying for their health insurance. Read this section to see if you qualify for the various tiers of assistance.

How can I protect myself?

“Section 8: Know your rights & protect yourself from fraud” (pages 89-100)

The U.S. government understands that health insurance can be confusing, and there are people out there that will try to take advantage of this confusion. Read this section to know how to protect yourself from health care and insurance fraud.

In addition, Section 8 also explains your rights under Medicare and how to make an appeal if you decide your rights have been violated. The Medicare and You 2020 book defines an appeal as “…the action you can take if you disagree with a coverage or payment decision by Medicare or your Medicare plan.”

How do I get my questions answered?

“Section 9: Get more information” (pages 101-112)

Next, if you have questions related to Original Medicare, the handbook offers you the following numbers to call:

1-800-MEDICARE (1-800-633-4227)
TTY users call 1-877-486-2048
Get information 24 hours a day, including weekends

Medicare and You 2020

Additionally, for questions regarding insurance plans like Supplement (Medigap) or Medicare Advantage (MA/MAPD) then we suggested talking to a licensed insurance professional.

If you are lucky enough to live in our headquarters of Nebraska or our neighboring state of Iowa, you can give Carly a call/text or email.

Related Article: Please see our Frequently Asked Questions page, and if you have a question, please leave it in the comments section or email us. Thanks!

What does this word mean?

“Section 10: Definitions” (pages 113-116)

Do you just live to read a good glossary? Well, here you go. You will find here definitions to all the health care and insurance lingo you need to know to navigate your health care effectively.

Related Article: Feel free to look through all our Medicare Articles. They are all listed on this page.

Medicare and You 2020 Handbook Review

We hope our review of the 2020 Medicare and You Book has been helpful.

Our one hope for next year is that the book might be more helpful in pointing beneficiaries towards ways to find LICENSED independent insurance professionals that can help them in making decisions. These agents are the only ones required to stay licensed, tested and up to date on the plans that are out there. Moreover, this applies especially for the Medicare Advantage approved agents as they have to be re-tested every year on changes.

Finally, we are MedicareLifeHealth.com just don’t understand how people can be offering advice on plans – that change yearly – they have not be certified to explain.

Our advice? Find yourself a good agent, and make them work for you.

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Medicare Part A B C D

Medicare Part A B C D

Medicare Parts A B C D Explained

Medicare has four different parts: Medicare Part A B C D. Each of these parts serve a different function in our national health care system for seniors.

As an overview of Medicare:

Here is More Detail on in our Medicare Parts A B C & D Infographic

Medicare Parts A B C D Explained

Original Medicare Components

Parts A & B come together to form “Original Medicare.” We have a detailed article on Original Medicare for you to read here.

If you are interested in the costs associated with Original Medicare Parts A and B, please visit our article “How Much Does Medicare Cost?

Medicare Part A Hospital Insurance Covers

Part A is dedicated to Hospital Insurance and covers care for…

  • Inpatient Hospital
  • Skilled Nursing Facilities
  • Hospice
  • Home Health

When you visit the hospital, Medicare will help you pay for the above services. However, Original Medicare does not pay for all of it. There are copayments, coinsurance, or deductibles may apply to each service. This is why most Medicare Beneficiaries will supplement Original Medicare with either a Supplement (Medigap) plan or a Medicare Advantage Plan.

Remember, Medicare does not cover Long-Term Care costs such as Nursing Home or Assisted Living Expenses.

Medicare Part B Medical Insurance Covers

Part B consists of Medical Insurance and covers the care of…

  • Outpatient
  • Home Health
  • Doctors
  • Health Care Providers
  • Durable Medical Equipment
  • Prevention

Again, Medicare will only cover some of these costs. You will also have copayments /coinsurance / deductibles that accompany these services. We highly recommend finding a Med Sup or Med Advantage plan to help you pay for the extra costs.

Additional Components of Medicare

Now that you understand the components of Original Medicare (Parts A & B), let’s look at the two additional parts of Medicare – Parts D and C – Drug Coverage and Medicare Advantage.

Medicare Part D Prescription Drug Insurance Covers

Part D is regulated by the government but handled by private insurance companies. This part includes care for…

  • Prescription Drugs
  • Covered Vaccines

To learn more about Part D Prescription Drug Coverage, please read our article about it here.

Medicare Part C – Also Known as Medicare Advantage (MA/MAPD)

MA / MAPD Plans are becoming more popular and more accessible to Medicare Beneficiaries all over the United States. Moreover, as more and more people are joining them, they are becoming very affordable options.

These plans offer additional benefits and services to what Original Medicare can offer such as dental benefits, vision benefits and hearing benefits. They also often include wellness benefits such as free gym memberships.

Read this article to learn even more about Medicare Advantage.

Medicare Parts A B C D Further Reading

If you would like the Parts of Medicare explained in even more detail, we shall direct you to our review of Medicare and You 2020. This is a User’s Guide to the government’s Medicare and You 2020 Handbook which has the yearly updates for what is available in the current plan year. In this case, 2020, when our article was published.

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Biggest Medicare Mistakes

Biggest Medicare Mistakes

The 5 Biggest Medicare Mistakes and How to Avoid Them

No one wants to make a mistake that will cost them hundreds (or thousands) of dollars down the road if they can help it! However, Medicare can be very confusing, and even very knowledgeable people can miss things. Here are the five biggest Medicare mistakes people make, and how you can avoid them!

#1 in Our Biggest Medicare Mistakes: Missing Enrollment Deadlines

Although the government gives us all a little wiggle room around each Medicare Milestone we pass, there are certain deadlines you must mind to avoid late penalties and inconveniences.

Original Medicare Coverage Deadlines

five biggest medicare mistakes and how to avoid them

You will need to sign-up for Medicare when you turn 65 if you are not already getting Social Security. You will be automatically signed-up for Medicare if you are getting Social Security. In addition, you will need to tell the government if you are delaying Medicare because of other credible coverage (such as an employers coverage).

You will have three months before your birthday to sign-up, the month of you birthday, and then three months after to sign-up. However, what some people do not understand, is that if you enroll after you turn 65, your coverage will not start until the first of the month after you enroll. This could lead to a gap in your health care coverage.

A NOTE ON CREDIBLE COVERAGE: Some people will delay Medicare coverage if they have a good health plan from their employer. This is usually okay, but there is an exception for small business employers to be aware of: If your employer has less than 20 employees, you will need to enroll in Medicare right away when you turn 65.

This is because when you work for a small business, their insurance will become secondary insurance and Medicare will be your primary payer. If this is the case, you will need to enroll right away in Medicare to avoid a penalty. (Also note that Cobra is not credible coverage.)

Medigap Guaranteed Enrollment Deadlines

The last Medicare Enrollment Mistake people make is missing their Guaranteed Enrollment period for a Medigap Plan. You will have six months, from the beginning of the month you first turn 65, to enroll in a Medigap plan with a guarantee to be issued a policy. If you apply after this window, you will have to go through medical underwriting. This means that companies have the right to deny issuing you a policy based on your medical history after your open enrollment is over.

It is important to remember that Medicare Advantage Plans have a different enrollment process than Medigap. The Medicare Advantage Annual Election Period is not for Medigap Plans. Which lead us right into Mistake #2…

Medicare Mistake #2: Not Understanding Medigap Plans vs. Medicare Advantage Plans

There are two main ways you can set up your Medicare Health Care Plan: Medicare Advantage (Part C) and Original Medicare with a Medigap Plan. You either have one or the other, not both. Both can be good ways to set up your health care, but not understanding how they work can lead to making on of our biggest Medicare mistakes.

We have a whole article on Medicare Advantage vs. Medigap Plans here. I suggest reading it if you are unfamiliar with the two plan types. Considerations with these plans include how you get your Prescription Drugs and how you want to budget your money. Cash flow can be different plan to plan with premium payments and out of pocket expenses to consider when making a decision. Your lifestyle needs and travel patterns also need to be considered when making a choice between MA and Medigap.

Mistake #3: Assuming Your Doctors and Drugs are Covered

We all know what assuming can lead to… mistakes! It is very important to make sure that your doctors are covered with the Medicare option you choose. The carrier will be able to help you confirm that you will be able to continue with your current doctor if you so desire. If you are working with an Insurance Agent, they will have the ability to do this for you as well.

Checking your drug options with a plan is also an important part of finding coverage. The government does make sure that at least two kinds of drugs are available per category of treatment. Moreover, carriers will have a process for you to make an exception for a drug not on its list (called a formulary). However, it makes for a smoother transition to check ahead of time to see what is covered for your specific needs.

Biggest Medicare Mistake #4: Assuming Medicare Covers Long-Term Care

It is a common mistake to assume that your Medicare coverage includes long term care – it does not. Skilled nursing facilities for recovery from a certain event are covered (and come with different co-insurances based on different plans). However, long term stays in assisted living and nursing homes are not covered. You will need to have a plan in place to cover these needs. Your planning may include, long term care insurance, IUL policies with long term care (or critical illness) riders, or self-insurance (paying cash).

Another option, for those that do not have a lot of resources saved up for retirement, is to “spend down” your assets to qualify for Medicaid to help you in paying for your care. However, I would not suggest this option for those that have the means to plan ahead for the level of care they desire or those that want to pass money on when they pass.

Biggest Medicare Mistake #5: Enrolling Directly with a Carrier

Ok, follow me on this one. When you first turn 65, you are bombarded with advertisements for different Medicare plans. Sometimes, it feels easiest to just pick up the nearest postcard and give that insurance company a call. Or maybe you have done your research on your own (which is just fine!) and decide to enroll directly with the carrier you want to go with. Here is where you should stop and consider this as a mistake.

Here is the problem: when you enroll with an insurance company for one of their plans directly, you have to deal with them alone. On the other hand, when you enroll with that same company through an independent insurance agent, you now have an advocate and support system to help you work with that carrier.

Here is how an independent agent helps:

  • First, if something goes wrong, you can call your agent for help! You are not on your own, and this is a big deal. As we all know, everyone can make mistakes – you, your doctor’s office, your insurance company. When these mistakes happen, you can call your agent for support and they can work with you and the insurance company to make sure you are taken care of.
  • Second, rates and plans change! A good independent agent will keep on top of industry changes and plan changes for you. They can stay on top of your premium rates and what might be new or changing in your area to make sure you always have the best coverage. You will not get this level of service when you work directly with a carrier.
  • Finally, you do not pay anything extra for working with an independent agent. They are still paid as an independent agent from Whichever company you are placed with at no charge to you.

Medicare Mistakes Summary

In addition to this article, another great resource is the Medicare and You book put out by the government. Since this is a large (120 page) document, we have created a Medicare and You User’s Guide for you to read and reference here.

In summary, you can avoid the biggest Medicare mistakes with a little research and a little help.

Reach out to a professional to answer any of your market specific questions and find out more about Medicare, Medicare Advantage, Medicare Supplements, and their differences here on MedicareLifeHealth.com.

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How Much Does Medicare Cost?

How Much Does Medicare Cost?

How Much Does Medicare Cost?

Medicare costs can be different person to person, depending on which type of plan you choose. After you have a basic understanding of Medicare and it’s basic components, you will want to know how much does Medicare cost? The answer is, it depends on how you structure it. Let’s break down what you could be paying.

Medicare Costs Broken Down & Made Simple

When you set up your Medicare, you will decide if:

Your costs will also be different if you get help in any way from any state or federal programs.

How Much Original Medicare Costs

  • Medicare Part A – For most people, there is not a cost or premium you pay for Part A. Your Part A is premium free if you worked in the US and paid Medicare taxes for at least 30 quarters. (You will pay between $240 – $437 a month depending on your work history for Part A if you do not meet the premium free requirements).
    • There is also a $1,364 yearly deductible for Part A services and coinsurance tiers on hospital stays.
  • Medicare Part B – You will pay a premium for Part B. In 2019, the standard premium is $135.50 per month. If you make more than $85,000 a year in retirement, you will pay more on an income dependent scale.
    • There is also a $185 Part B deductible and a 20% coinsurance (co-pay) for most approved services.
    • Late penalties may also apply to Part B (and less commonly, Part A) if you do not sign-up when you are first eligible.

How Much Prescription Drug Costs

Medicare Part D Prescription Drug Plans

Medicare Part D – Prescription Drug Coverage needs to be obtained from a private insurance company. Each company will price their service differently and you can shop for the best plan and price for you. In addition, you will pay more for your Part D coverage, on a sliding scale, if you make more than $85,000 a year while on Medicare.

Other costs to consider with your Part D coverage are co-pays and coinsurance, in addition to deductibles.

There are also late enrollment penalties associated with not signing up for Part D coverage when you are first eligible if you do not have “credible coverage.”

How Much Medicare Supplements or Medicare Advantage Plans Cost

On top of your Original Medicare, you will need to make a decision to either participate in a Medicare Advantage (Part C) plan or to consider having a Medigap (Medicare Supplement) Plan. If you need help deciding on which one is best for your needs, please read our article on Medicare Advantage Vs. Medicare Supplements.

  • Medicare Supplement Plan Costs – Medicare Supplements will each have a different cost depending on the Letter Plan you choose and the company you go with. The government decides what benefits are offered by each letter plan. Then, each private insurance company decides what price they can offer for each plan in each market. It is a good idea to compare multiple plans by multiple carriers (insurance companies) in your area before choosing a plan. An independent insurance agent will be able to help you do this.
  • Medicare Advantage (MA/MAPD) Costs – Part C, or Medicare Advantage Plans are also offered by private insurance companies and stand in place of Original Medicare. In addition, they often include Part D Prescription Drug Coverage. Some of these plans have low or zero premium plan options. A few even cover Part B premiums. All of them are required to have max out of pocket expenditures and deductibles. It is a good idea to talk to an independent insurance agent on MAPD plans in your area to help you choose your best option.

Medicare Costs Summary

In summary, Medicare will cost you something, unless you are on full benefits from Medicaid. Moreover, you have already been paying into the Medicare system during your working career with Medicare taxes. Common set-up for Medicare beneficiaries include:

  • Having Original Medicare, Part A Premium Free, Part B Premium at $135.50 /month and a stand alone Part D Premium to pay. Then, adding on a Supplement Plan to cover the expenses Original Medicare does not pay.
  • Or having a Part C Medicare Advantage Plan that includes a drug plan with a premium to pay (sometimes a $0 premium). Most commonly, you will still pay your Part B premium with Medicare Advantage.

Get More Help Understanding How Much Medicare will Cost You

One good resource for learning more about the costs of Medicare is the Medicare and You Book published by the government every year. It is a large book, so please star with our Medicare and You User’s Guide to learn what it offers and to get a copy if you need one.

In addition, finding the best Medicare options for your budget can be a lot to take on, but hopefully this breakdown is helpful. I strongly suggest talking to a professional to help you in setting up your Medicare plan. As an independent agent myself, I suggest using an independent agent. They are not tied to one company, so they work for you, not one carrier and can help you in considering many different carriers and plans.

Carly Cummings, Medicare and Medigap Expert

As always, if you live in Nebraska or Iowa, please give me a call, and I can help you out either in person or over the phone.

Carly Cummings, NE/IA Licensed Independent Insurance Agent for Life and Health.
how much does medicare cost?
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Medicare Penalties For Late Enrollment

Medicare Penalties For Late Enrollment

What are the Medicare Penalties for Late Enrollment?

There are two main Medicare penalties for late enrollment to be aware of when you are planning your health care in retirement. The first is the Part B late enrollment penalty, and the second is the Part D late enrollment penalty. Let’s look at both penalties and how you can avoid them.

Part B (and Part A) Late Enrollment Penalties

As you may recall, there are two parts to Original Medicare – Part A and Part B. Most people will get Part A without paying a monthly premium. Part B has a premium you pay for. As a result, the Part B late enrollment penalty is more common. Just to be through, we will cover both.

When Do These Part A/B Late Enrollment Penalties Apply?

The Medicare Part A and B Late Enrollment Penalties apply to those people who do not have “credible” health care coverage when they age into Medicare at 65. What if you have health care with your employer at 65? Then, you will let the government know you will be delaying your use of Medicare until that coverage ends. In this case, you would not have a penalty.

Part D Late Enrollment Penalty

The Part D Prescription Drug Coverage part of Medicare also comes with a late enrollment penalty. It applies if you do not sign-up when you are first eligible or if you go 63 days or more without coverage at any point. In addition, late penalties are added to your Part D premium for as long as you have Part D.

How much you pay as a penalty can be calculated with a little basic math whipped up by the government:

Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($33.19 in 2019 and $32.74 in 2020) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

Straight from this page on Medicare.gov

When Does the Part D Late Enrollment Penalty Apply?

If you are eligible for Medicare and do not have Part D coverage or other credible coverage (i.e. from an employer plan) for over 63 days, you will get a penalty. The penalty will not apply to those with credible coverage. This can be from work health plans, VA drug plans, and Part C (MAPD) plans. Of course, from Part D Prescription Drug Plans are credible coverage as well.

Late Enrollment Penalties Summary

In summary, you can avoid the Medicare late fees and penalties with a little bit of planning and research. One great resource for learning more about these penalties is the U.S. Government’s Medicare and You Guidebook. You can read our User’s Guide/Review of this book (and learn how to get a copy if you need one) here.

medicare penalties for late enrollment
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