Medicare Part B enrollment: Avoiding penalties and everything else you need to know

Apex Blog - How can I avoid paying Medicare Part B enrollment penalties

If you’re getting ready to turn 65, happy early birthday, and congratulations – you will soon be ready to enroll in Medicare, a federal government health insurance program available to people aged 65 and older. (There are other groups of people who can receive Medicare, but let’s leave that aside for now.) At ApexHealth, we want to make sure you know important details about Medicare to make sure you get the coverage you need without being hit with enrollment penalties. Here are some questions and answers about Medicare Part B enrollment that we think you’ll find helpful.

Am I automatically enrolled in Medicare, or do I need to apply?

Enrollment in Medicare Part A and B is handled in two ways, you are either automatically enrolled or you must apply:

  • You are automatically enrolled if you are already receiving Social Security benefits or are disabled and receiving Social Security benefits or Railroad Retirement benefits for 24 consecutive months.
  • You will need to apply if none of these scenarios apply to you.

You can sign up for Medicare by contacting Social Security. You can do so online, over the phone at (800) 772-1213 (TTY: (800) 325-0778) or by contacting your local Social Security office.

When am I first eligible to enroll in Medicare?

You are first eligible to enroll in Medicare three months before you turn 65. You have a seven-month window to enroll, known as your Initial Enrollment Period (IEP), which includes the three months before, the month of and three months after your 65th birthday.

When does my Medicare Part B coverage become effective?

The day your coverage goes into effect depends on when you enroll during your IEP. The table below helps break it down.

I enrolled during this time of my initial enrollment period:This means that my Medicare Part B coverage starts:
One to three months before the month I turn 65The month I turn 65
The month I turn 65The next month
One month after I turn 65Two months after I enroll
Two or three months after I turn 65Three months after I enroll

What happens if I miss my seven-month initial enrollment period? 

If you miss your seven-month IEP, unfortunately, you will not be able to enroll in Medicare until the next general enrollment period which takes place from January 1 through March 31. But remember, your benefits will not go into effect until July 1. This could leave you with gaps in your health care coverage, plus you will be hit with enrollment penalties. Your Part B premium will go up by 10 percent for each 12-month period you wait to sign up, and unfortunately, this increase is permanent.

Can I delay Medicare Part B enrollment?

Most people receive Medicare Part A benefits premium-free if they’ve worked 10 years, so there is not really a reason to delay this coverage. However, there is a premium associated with Medicare Part B that most people must pay. This means that if certain circumstances apply, you can delay Part B enrollment to avoid paying this premium.

You can delay Medicare Part B enrollment if you’re 65 or older and covered under a group health plan or your spouse’s group health plan, or if you are disabled and on a group health plan you may delay enrolling in Part B. Remember that you can enroll in Part B anytime while you are covered under a group health plan. You can also enroll in Part B during the eight-month period that begins the month after employment ends or group health plan coverage ends, whichever comes first. This is known as a Special Enrollment Period (SEP).

How can I avoid paying Medicare Part B enrollment penalties and any gaps in my health care coverage?

We understand there is a lot of information here to unpack, and no one wants to end up having to pay an enrollment penalty. The ApexHealth team has a few quick words of advice for you:

  1. As you get closer to your 65th birthday, plan ahead. Find out when your IEP is, decide when to enroll in Medicare Part A and Part B, and determine if you want to and are able to delay Part B enrollment and find out how to enroll. We recommend making a decision at least three months before your 65th birthday.
  2. If you’re thinking about delaying Part A or Part B, reach out to your employer or benefits administrator to find out more information on how your coverage works with Medicare. Everyone’s situation is different.

It’s always smart to plan ahead! And if you have any questions along the way, ApexHealth has your back. Give us a call at (844) 279-0508 (TTY: 711). Our hours of operation are Monday through Friday 8 a.m. – 8 p.m. (local time) from Apr. 1 through Sept. 30 and seven days a week 8 a.m. – 8 p.m. (local time) from Oct. 1 through Mar. 31.

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