Medicare late enrollment ends March 31 each year

Silver Tips is written by the Senior Citizens’ Law Office in Albuquerque.

Most people get Medicare when they turn 65, or two years after they begin receiving Social Security disability benefits. If they or a spouse paid Medicare taxes while they were working, they automatically receive Medicare Part A (hospital insurance) benefits for free. They can also enroll in Medicare Part B (medical insurance) for a small monthly premium.

Some people decline enrollment in Medicare when they first become eligible. They may have other health insurance, or they may feel they are healthy enough not to need health coverage at that time. But unless you have an employer-provided group health plan, declining Medicare is not recommended. If you turned down Medicare when you were first eligible, then change your mind and want to enroll, it is considered a "late enrollment" and carries two penalties.

The first penalty restricts your enrollment period to only the first three calendar months of the year (January through March). Your coverage does not begin until July of that year.

Secondly, the Part B premiums for late enrollees are increased above what everyone else is paying. The penalty for signing up after age 65 for Part B coverage is a 10 percent increase for each year of delayed enrollment. This "premium penalty" stays in place for as long as you have Medicare coverage.

People who are covered under certain employer-provided group health plans, however, can enroll in Medicare up to 8 months after that coverage ends, and not be penalized. If you mistakenly declined Medicare when you were first eligible for it, or declined it as a result of mistaken or inadequate information, it is possible to request a waiver of the late enrollment penalties.

Despite the penalties, late enrollment in Medicare is usually better than not enrolling at all. The coverage is likely to be far less costly than any private health insurance, and you may not be able to buy any other coverage if you are in poor health. If your income and assets are low enough to qualify for full Medicaid or for a Medicare Savings Program (QMB, SLMB, or QI), your increased Medicare premiums would be paid for by the state.

Some people aren't able to qualify automatically for Medicare at age 65 because neither they nor a spouse have worked enough years of Medicare-taxed employment. They can still enroll in Medicare, but their premiums for Part A can be as much as $316 per month. They're likely, however, to have incomes low enough to qualify for full Medicaid or for a Medicare Savings Program to cover both their Part A and Part B premiums. Late enrollees who are low income can sign up for Medicare on a "conditional" basis, then apply for Medicaid or a Medicare Savings Program, and then cancel their Medicare (if they want to) before July 1 if their application for state assistance is denied. Anyone who wants to apply for late enrollment in Medicare this year must do so before March 31 for coverage to start in July. All local Social Security offices have the applications. After March 31, they will have to wait until next year to enroll in Medicare.