More than 55 million Americans are enrolled in Medicare. Every year, after their 65th birthdays, men and women must enroll for Medicare Advantage and Part D prescription drug coverage between Oct. 15 and Dec. 7. But many forget to sign up, or they think they don’t have to because they have private insurance through the Affordable Care Act. They are mistaken, which can lead to a ton of headaches, not to mention big penalties.
There is good news. Medicare, the government-mandated health insurance program for older people, has temporarily suspended its rules and is waiving the late-enrollment fees for anyone who became eligible for Medicare Part B, which covers outpatient care and physician visits.
NPR and other media outlets reported a Medicare spokesman who said officials made the change because many people “did not receive the information necessary … through the marketplace to make an informed decision.”
People have been required to sign up for Part B within three months before or after turning 65 if they aren’t getting job-based insurance, or when their job-based health insurance ends if they are older than 65, according to Medicare rules. If someone younger receives disability checks, he or she can qualify for Part B after two years.
But those who qualify for Medicare will lose subsidies if they choose to remain in plans purchased on the federal or state exchanges under the rules of the Affordable Care Act. Until now, that caused premiums to skyrocket. One woman from St. Louis told NPR that her sister’s marketplace rate ballooned from $50 a month to $360 a month because she thought she didn’t have to enroll.
People age 65 and older who have a private insurance plan or had one they lost or canceled, as well as people who qualify for Medicare because of a disability, could qualify for the penalty waiver, or at least a reduction. They now have until Sept. 30 to request the waiver.
“This has been a problem from the beginning of the Affordable Care Act because the government didn’t understand that people would not know when they needed to sign up for Medicare,” Bonnie Burns, a consultant for the consumer group California Health Advocates told NPR. “Once they had insurance, that relieved all the stress of not having coverage and then when they became eligible for Medicare, nobody told them to make that change.”
For more information, visit the Medicare Rights Center at medicare rights.org.
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