Q: I am on Social Security and Medicare Part A only because my wife is still employed and I have doctor coverage under her plan. I recently received a letter from the Department of Health & Human Services stating that if I do not take Part B now that the amount I have to pay will go up 10% for each year I delay signing up. Is this correct and is there any way I can prevent this from happening? — D.N.
A: Under Medicare rules there can be a penalty for late Part B enrollment. If you enroll after your “initial enrollment period” or re-enroll after terminating previous enrollment, the monthly premium will be increased by 10% for each full 12-month period in which you were not enrolled.
There are special rules, however, for persons and their spouses who receive their health coverage through large employers. Generally you are allowed to wait to sign up for Medicare Part B if you or your spouse are still working and have health coverage through you or your spouse’s employer or union. Health plans through large employers are the primary payers and Medicare the secondary payer.
This is NOT the case, however, if your spouse is working for a small company of less than 20 employees. Under health insurance arrangements for small companies, Medicare is the primary payer and your group health insurance is the secondary payer. That means that the Part B late enrollment penalty does apply if your spouse receives insurance through a small company.
If your spouse is working for a large employer and you don’t take Medicare Part B when you are first eligible, you can sign up for Medicare Part B during a Special Enrollment Period. You can sign up:
Anytime you are still covered by the employer or union group health plan through your or yours spouse’s current or active employment, or
During eight months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first).
According to Medicare, most people who sign up for Medicare Part B during a Special Enrollment Period do not pay higher premiums. I suggest that you call Medicare at 1-800-MEDICARE (1-800-633-2273) to ask about the notice you received and confirm what steps you should take. Take careful notes of the date and time of your call, what you are told, and be sure to get the name of the person you speak to. Please note that when the time comes to enroll in Medicare Part B, the Social Security Administration handles Medicare enrollments.
June 2004
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