Late Medicare Enrollees May Not Receive Penalties

Late Medicare Enrollees May Not Receive Penalties

If you’re worried that you missed the deadline for Medicare Part B, you still have a chance to avoid penalties. This is especially important for those who have yet to work out their financial planning in this regard.

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Medicare Changes the Rules

Thousands of Americans miss their chance to enroll in Medicare each year. Consumer advocates and federal officials worry that many of them mistakenly believe that they do not need to sign up as they have bought insurance on the health law’s marketplaces. This mistake can bring on a lifetime of enrollment penalties. Because of this, Medicare has temporarily changed its rules to provide a reprieve from penalties for those who have kept the Affordable Care Act even after becoming eligible for Medicare. Now people have until September 30, 2017, to request a waiver of the usual penalty.

 Explaining the Change

Elaborating on the change in policy, a spokesperson from enrollment stated that many of these people didn’t receive proper information when they became eligible for Medicare, or when they initially enrolled in coverage via the marketplace. This information is vital in making informed decisions regarding Medicare enrollment.

These people can now request a waiver to avoid the penalty that Medicare would typically assess if they were delayed in signing up for Medicare Part B, which covers outpatient care and visits to the doctor among other things. Beneficiaries who already pay the penalty because they had a marketplace plan can now request a reduction or elimination of the fee. It also enforces a waiting period that offers coverage to people who don’t sign up when they become eligible first. If they meet the waiver requirements now, they can request it to be lifted.

To qualify you must be 65 or older with a marketplace plan or have had one that was previously canceled or lost. It also includes those with disabilities that qualified for Medicare but opted for using a marketplace plan instead.

Complications

Bonnie Burns, a consultant for the consumer group California Health Advocates, has stated that the government has failed to understand that people won’t know when they need to sign up for Medicare. Once people have insurance, it relieves all the stress of not having coverage. When they are eligible for Medicare, they are typically not informed that they needed to make the appropriate changes.

The Requirements

As a standard rule, a person needs to sign up for Part B within three months before or after turning 65 if they are not receiving job-based insurance, or when their job-based insurance has ended. Most people that are under 65 and receiving Social Security disability benefits also qualify for Part B after 24 months of benefits.

Per the health law, people who qualify for Medicare would lose subsidies when they opt for the online exchange plans, and enrolling in one of those plans doesn’t protect them from a permanent late enrollment penalty.

Burns said that marketplace insurers can usually spot when a member is turning 65 but they are barred under the health law from canceling coverage because that member may qualify for Medicare. They are required to cancel subsidies of a Medicare-eligible member.

More Efforts Needed

Stacy Sanders, Federal Policy Director at the Medicare Rights Center, has stated that the rules are very complex, and a lack of good notification led people down a dangerous path where they had to deal with declining or delaying Part B.

People who enroll in Part B 12 months or more after becoming eligible can face a permanent penalty of 10 percent. This penalty is added to the Part B premium for each full 12-month period. This year, the Part B average monthly premium was $109 USD.

Last summer, the Medicare officials sent emails each month to around 15,000 people with subsidized coverage via the federally run marketplace. These notices targeted those approaching their 65th birthday to tell them how they can avoid an unwanted overlap in Medicare coverage and Marketplace coverage. Officials had also begun to contact the people who already had both Medicare and subsidized marketplace coverage. They urged such people to discontinue the latter. But still, the warnings missed some people.

Medicare began emailing letters regarding a temporary waiver in March to some people who are 65 or older and are enrolled in plans which are sold on the marketplaces. However, the federal government has failed to reach out to others who might be eligible.

How To Apply

If you need more information regarding application, visit the Medicare Rights Center’s Interactive web page. You may also call the center’s help line at 800-333-4114.

Raising awareness is the best way to prevent future complications. However, this waiver should hopefully aid in putting those at ease who were originally at risk of long term penalties.

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