Delayed Enrollment in Medicare Part B

Delayed Enrollment in Medicare Part B

When it comes to delayed enrollment in Medicare Part B, there are multiple factors to consider.  There are valid reasons why someone should and could delay enrollment in Medicare part B without a penalty.  However, the rules for who can delay are very specific. Failure to follow them can lead to delayed enrollment penalties in the future.  Read further to make sure you are following the rules.

Who should consider delayed enrollment in Medicare Part B?

The majority of people turning 65 should enroll in both Medicare Part A and Medicare Part B.  Part B has a monthly premium that is either deducted out of the Social Security check or billed quarterly for those not receiving Social Security payments.  Those receiving SS payments when they turn 65 will be automatically enrolled in Medicare.  Those not receiving SS payments will need to manually enroll either at a local SS office or online CLICK FOR ONLINE ENROLLMENT

For some people it may make sense to delay enrolling in Medicare part B.  This often is the case for those that are working past the age of 65 or those getting coverage through a spouse working past age 65,  There are three specific conditions that need to be met in order to waive Medicare Part B and not be subject to a penalty down the road.

Delayed enrollment in Medicare Part B:  Conditions to waive B

· Actively working or getting coverage through an actively working spouse.  If you are working and getting coverage through work, you may be able to waive Medicare Part B.  Same goes for someone that is getting coverage through a working spouses employer coverage.

· Having coverage through the current employer. The coverage needs to be through the working spouse’s employer.  If the spouse is working but getting coverage through Cobra, a past employer or an individual plan of some type, you cannot waive Medicare part B

· The employer group most have 20 or more employees.  If the employer has less than 20 employees you should enroll in Medicare Part B even if still working and getting coverage through work

Comparing the employer coverage to Medicare

Just because someone is meeting the criteria to waive part B does not mean the necessarily should.  The current employer plan monthly cost and benefits need to be compared to the cost of Original Medicare with a supplement and Part D drug plan or with a Medicare Advantage plan. It is simply a matter of seeing which way will provide more benefits for less premium.

Other things to look out for

· Delayed enrollment in Medicare Part B can tricky.  For example: VA coverage is a valid waiver for Medicare Part D (drug coverage) It is NOT, a valid waiver for Medicare Part B

· Cobra can be a valid waiver for Medicare Part D but it is not a valid waiver for Medicare Part B

· Working but having coverage through a plan from a former employer or COBRA is not a valid waiver for Part B

· PEO:  If you work for a small group less than 20 that is part of a PEO you may have an exception to the group of 20 or more rule.  Some PEO’s have a waiver for all their groups which allows the ones with less than 20 employees to be considered a group of 20 or more.

Delayed enrollment in Medicare Part B: Change in the Medicare GEP

Those who miss their initial enrollment in Medicare Part B have two possible election options.   The first is a Part B special election period and the second is the Medicare Part B general election period.

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