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How Can I Avoid Medicare Late Enrollment Penalties?

The best way to avoid late enrollment penalties is to use your IEP, or SEP if you are eligible. There are also a few ways to make an argument against late fees.

What Are the Medicare Late Enrollment Penalties?

When you first become eligible for Medicare, you have 3 months prior to, the month of, and 3 months after your 65th birthday to enroll during your Initial Enrollment Period (IEP). During this time, you will not be charged any late enrollment penalties, simply because you are not enrolling late.

After this period ends, however, you are subject to Part B and D late penalties. You may also have Part A fees, but most people qualify for premium-free Part A and don’t have to worry about it.

For every 12-month period (1 year) you delay your Part B enrollment, the monthly premium permanently increases by 10%. Let’s say an individual enrolls in Part B 1 year after their IEP. As of 2021, the Part B premium is $148.50. This means that their premium would permanently be increased to $163.35.

For Part D, your penalty premium is calculated by multiplying the national Part D standard premium by 1% times the number of months you went uncovered while eligible. For example, if the national average is $33.06 and you waited to enroll for 6 months, your premium would have an additional $9.92 added on to it.

The Best Way to Avoid Late Enrollment Penalties? Don’t Enroll Late!

Of course, the absolute easiest way to avoid late penalties is to simply enroll on time. If you are considering Part B and Part D but are still not sure when it comes time to enroll, you may want to move forward and sign up then disenroll if you change your mind later. The good news, however, is that for Part B, many people are automatically enrolled, so you should be able to avoid that fee fairly easily.

No Late Penalties with the Special Enrollment Period (SEP)

The Special Enrollment Period (SEP) allows for exceptions to the penalty—if you’re eligible and enroll with it, you will not be charged extra. You are eligible for a SEP if you or your spouse are still working while eligible and choose to delay enrollment to opt for your employer health insurance.

Making an Appeal to Waive the Late Penalty

If you feel your late penalty is unfair, you must unfortunately still pay it by law. You may, however, request a reconsideration form from the Social Security office or your Part D provider. If you can provide viable documentation such as proof of employment that would disqualify you for the late penalty, you may be able to have it waived.

Navigate Your Medicare Enrollment with Swisher Insurance—Call Today

Medicare enrollment is tricky, especially if you have to worry about late penalties. Whatever your situation, Swisher Insurance will work out the best possible solution. Give us a call at 502-259-0780.

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