What Happens if You Don’t Enroll in Medicare Part A at 65?
Turning 65 is a major milestone. It’s also when you first become eligible for Medicare. So what happens if you don’t enroll in Medicare Part A when you turn 65? There can be serious repercussions if you don’t sign up for medicare at 65 on time.
When Do You Sign up for Medicare
First, it’s important to understand the different Medicare enrollment periods.
Your Initial Enrollment Period
This is the seven-month window around your 65th birthday when you can first sign up for Medicare Health insurance. It includes the three months before you turn 65, the month you turn 65, and the three months after your 65th birthday.
General Enrollment Period
This runs from January 1 to March 31 each year. It’s another chance to sign up for Medicare if you missed your initial enrollment window.
Special Enrollment Period
This provides an opportunity to enroll under certain circumstances, like losing other health coverage.
Penalty for Not Enrolling in Part A
Medicare Part A covers hospital services. It’s premium-free for most people because you or your spouse paid Medicare taxes while working. But what happens if you don’t sign up when first eligible?
You May Have to Pay a Penalty
If you don’t enroll in Part A coverage when you’re first eligible and then want to sign up later, you may have to pay a late enrollment penalty. This penalty is 10% of the standard Part A premium for every 12-month period you delayed enrollment. You’ll have to pay this penalty for twice the number of years you waited to enroll.
You Can’t Enroll Whenever You Want
Keep in mind that you can’t just sign up for Part A anytime. As mentioned above, you must enroll during one of the designated enrollment periods.
No Special Enrollment Period for Part A
Also be aware that there is no special enrollment period for Part A like there is for Part B. The only way to get Part A after your initial enrollment period is during the general enrollment period from January 1 to March 31 each year.
Pre-Existing Conditions Aren’t Covered for 6 Months
Another consequence is that if you enroll late, any pre-existing medical conditions may not be covered by Medicare for the first 6 months. This means you’ll have to pay 100% of costs for any care related to that condition.
Why You Shouldn’t Delay Enrolling in Medicare Part A
Given the ramifications, it’s typically advisable not to delay signing up for Medicare Part A when first eligible. Here’s why you should enroll on time if possible:
No Monthly Premium
As mentioned above, most people can get Part A premium-free based on their work history. Signing up late could mean having to pay a monthly premium.
Late Enrollment Penalties
You want to avoid owing late enrollment penalties, which can add up over time. Enrolling when first eligible lets you avoid penalties.
Get Coverage When You Need It
Health issues can crop up unexpectedly. Getting Medicare coverage in place when you turn 65 means you’ll have comprehensive coverage when you need it.
Coverage Gaps Are Costly
Any gaps in health coverage can lead to major out-of-pocket costs for medical care. Having Part A in force helps prevent gaps.
Lock In Lower Premiums
Medicare premiums may increase over time. Enrolling early locks in lower premium rates. Delaying could mean paying higher rates later.
Pre-Existing Conditions May Apply Later
Remember, pre-existing conditions may not be covered if you enroll late. It’s better to sign up early to avoid this issue.
Special Enrollment Period
While you generally want to enroll in Medicare when first eligible, there are some special instances where you may be able to wait:
Still Working with Employer Coverage
Some employer group health plans allow employees to remain on the plan and delay Medicare enrollment.
Have Retiree or COBRA Coverage
If you have solid retiree or COBRA coverage, you may be able to put off Medicare enrollment as well.
Covered Under Spouse’s Insurance
Likewise, if you’re covered as a dependent on your spouse’s employer plan, you may be able to hold off on enrolling in Medicare.
However, it’s essential to check with your benefits administrator to understand how your current insurance works with Medicare. You want to ensure you won’t face coverage gaps or late penalties before choosing to delay Medicare enrollment.
What to Do If You Missed Your Initial Enrollment Period for Medicare Part A
If you’ve missed your initial Medicare enrollment window, don’t panic. You still have options:
Sign Up During the General Enrollment Period
As discussed above, this runs from January 1 to March 31. Coverage would then start July 1. Just keep in mind you may face lifetime late enrollment penalties.
See If You Qualify for a Special Enrollment Period
This provides an opportunity to sign up if you meet certain criteria, like losing other coverage.
Understand Your Options to Supplement Medicare
If you have to pay Part A late enrollment penalties, Medigap or Medicare Advantage plans may help supplement coverage.
Talk to an Insurance Agent
Contact a licensed insurance agent to go over your options. They can help you understand how to handle late Medicare enrollment.
I’m Here to Help
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give Nick Boushay a call at (888) 508-1781. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.
Frequently Asked Questions
Turning 65 is an important milestone for enrolling in Medicare to avoid gaps in coverage and penalties. Some options exist to delay Medicare enrollment if you have other qualifying coverage. But in most cases, it’s wise to sign up for Medicare Part A when you first become eligible at age 65. Connect with an insurance broker to fully understand your choices.
What is the Part B late enrollment penalty?
The Part B late enrollment penalty is an amount added to your monthly Part B premium if you don’t enroll in Medicare Part B when you’re first eligible. The longer you wait to sign up for Part B after becoming eligible, the larger the penalty.
How can I avoid late enrollment penalties for Medicare?
To avoid late enrollment penalties, you need to sign up for Medicare during your initial enrollment period. This is the 7-month period that begins 3 months before the month you turn 65. Enroll in Part B as soon as you’re eligible to avoid paying penalties.
Q: What if I delayed enrollment in Medicare Part B?
A: If you delayed enrollment in Medicare Part B and didn’t have other coverage, you may have to pay a late enrollment penalty and pay this penalty as long as you have Part B coverage. However, you may qualify for a Special Enrollment Period to sign up and avoid penalties.
When do I need to sign up for Medicare?
A: You should sign up for Medicare during your Initial Enrollment Period, the 7-month period that begins 3 months before the month you turn 65. This will ensure you avoid late enrollment penalties and gaps in coverage.
What happens if I don’t enroll in Medicare Part B when I’m first eligible?
A: If you don’t enroll in Medicare Part B when first eligible, you may have to pay a late enrollment penalty for as long as you have Part B coverage. You’ll also have to wait for a General Enrollment Period to sign up, which only runs January 1 – March 31 each year.
How can I avoid the Medicare Part D prescription drug late enrollment penalty?
A: To avoid the Part D coverage late enrollment penalty, you must enroll in a Medicare drug plan when you’re first eligible. This is usually when you turn 65 and enroll in Medicare Parts A and B. As long as you have Part A or B, you can join a plan without penalty.
When am I first eligible for Medicare?
You become eligible for Medicare at age 65. Your initial enrollment period is the 7-month period that begins 3 months before you turn 65. Make sure to sign up on time to avoid penalties.
What are the penalties for not signing up for Medicare at 65?
If you don’t sign up for Medicare Parts A and B at age 65, you may face late enrollment penalties, have gaps in coverage, and only be able to enroll during the General Enrollment Period from January 1 to March 31. Avoid penalties by signing up on time.
How does Medicare supplement insurance work?
Medicare supplement insurance helps pay costs not covered by original Medicare like copays and deductibles. You must be enrolled in Medicare Parts A and B to qualify for a Medicare supplement policy. These plans are offered by private insurance companies.
What do I need to know about enrolling in Medicare drug plans?
To avoid a penalty, you should enroll in a Medicare Part D drug plan when you’re first eligible, usually when you turn 65. As long as you have Medicare Part A or Part B and social security, you can join a plan without penalty. Compare