Medicare questions: On late enrollment and other what-if scenarios

This week’s column addresses some Medicare questions from readers.

Question: What if I did not enroll in a Medicare Part D plan when I turned 65 and I am taking an expensive medication? When can I enroll in Part D?

Answer: When one fails to enroll in a Medicare Part D plan at the right time, then Medicare’s annual enrollment period (Oct. 15 to Dec. 7 each year) is when you can enroll in a stand-alone Part D plan or a Medicare Advantage plan with Part D. The new plan will begin Jan. 1 with you receiving a Medicare Part D penalty for not enrolling at the proper time. For help with prescription drug planning, contact the Toni Says Medicare team.

What if I am on a limited income and cannot afford my Part B premium or prescription drug cost?

Contact the Medicaid office and see if you qualify for its qualified Medicare beneficiary program or specified low-income Medicare beneficiary program. Call your local Social Security office or apply online for “extra help” if you do not qualify for Medicaid. Each year the income qualifications change.

What if I did not enroll in Medicare Parts A and B when I should have, because I do not want to pay that extra Part B premium each month? I do not go to the doctor, and I do not take any prescriptions. Can I enroll later?

If you are past 65 years and 90 days old, not working full time with true company benefits and decide to enroll in Medicare Part B, then you will have a big Medicare problem. You must wait until Medicare’s general enrollment period (Jan. 1 to March 31 each year) to enroll. You will receive the infamous Medicare Part B penalty, which is a 10 percent increase in your Part B premium for each 12-month period that you could have had Part B. You will pay this late enrollment penalty for as long as you are on Medicare. With no Medicare Part B, you will have to pay 100 percent out of pocket for medical care.

What if I am past 65, have retired from work with company benefits and need to enroll in Medicare Part B. What do I do?

If you are retiring or have been laid off past age 65, we recommend that you have your employer sign Social Security form CMS-L564, “Request for Employment Information,” and attach it to form CMS-40B, “Application for Employment in Medicare Part B.” Take both forms to your local Social Security office to enroll in Medicare Part B as quickly as possible. Once you enroll in Medicare Part B, you only have 63 days to get Medicare prescription drug coverage.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.