Missed the Medicare Enrollment Deadline?
You might still have a chance to avoid the penalties.
Timing is everything! Generally, if you miss an enrollment deadline, you will need to wait until the general enrollment period (GEP) and most likely pay the penalty. However, there are special enrollment periods (SEP) you might qualify for. If you do, you don’t have to pay any penalties. This means you can sign up outside our initial enrollment period, which starts three months before you turn 65 and lasts up to three months after.
When do you qualify for the special enrollment period?
If you or your spouse still work(s), and you have health insurance through either of your employers.
- You can still sign up for Medicare part A, most people don’t have to pay a premium, and it will cover hospital expenses. You won’t have to pay a premium if Medicare taxes are deducted from your or your spouse’s paychecks for at least ten years.
Missed the deadline? No worries, you might be able to delay your enrollment without having to pay for any penalties. Depending on your plan through work, you may not need to enroll in Medicare part B or D. If you do have creditable coverage through work, keep the Certificate of Creditable Coverage in your records as proof. You will likely need to use this as proof that you had creditable coverage later. Plan to enroll before your employer coverage ends to avoid penalties due to a gap in your coverage.
For Part B, you’ll need to sign up before your employer coverage ends or within eight months of losing your job-based coverage to avoid a late-enrollment penalty.
For Part D, you’ll have a shorter special enrollment period — two months after the month that your previous prescription drug coverage ends.
When your employment-based health insurance ends, you can sign up for Part B during the special enrollment period. After that, you can sign up for a Part D prescription drug policy and a Medigap policy, covering most of Medicare’s deductibles and copayments. You could also purchase a private Medicare Advantage plan, which provides medical and drug coverage.
Click here to learn more about if it’s better to keep your employer’s coverage or enroll in Medicare
When should you enroll in Medicare to avoid penalties?
Medicare’s sign-up window starts three months before your birth month when you turn 65 and ends three months after. You will have to enroll in Medicare during this sign-up window to avoid penalties unless you have creditable coverage (ex., employer health insurance plan).
You will have guaranteed issue rights during your initial enrollment period; insurance companies can’t deny you a Medicare Supplement insurance plan because of pre-existing health conditions or disabilities.
Late Enrollment Penalty part B: Your monthly Part B premium could be 10% higher for every entire 12-month period that you were eligible for Part B.
That means one year is 10%, two years is 20%, three years is 30%, and so on.
For each month you delay enrollment in Medicare Part D, you will have to pay a 1% Part D late enrollment penalty (LEP). The penalty is calculated based on 1% of that year’s national average Part D premium.
For example, the national average for 2023 is $31,50, so if you went 18 months without credible prescription coverage, your penalty would be as follows: $31,50 x 1% = $0.315 x 18 months = $5.67 penalty per month.
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Enrollment period overview
- Initial Enrollment Period: Lasts for seven months; your sign-up window is from 3 months before your birth month when you turn 65 to 3 months later. You have to enroll in Medicare during this sign-up window to avoid potential penalties. If you don’t register in time, you may have to pay the penalty for parts B and D.
- Annual Enrollment Period: Anyone can use the AEP to make changes to their Medicare coverage – from October 15 to December 7
- Open Enrollment Period: January 1 to March 31
- Lock-in Period: April 1 to December 31
- Special Enrollment Period: Special circumstances within the year
- Medicare Birthday Rule: The Medicare birthday rule allows consumers to change to an equal or lesser benefit Medigap policy within a 60-day window without medical underwriting (not available in all states).
Click here to learn about the steps you need to take to sign up for Medicare