04/20/2025
This is a question I get often. Mostly everyone who is 65 or over and not retiring is worried about being penalized.....in some cases you should be. So here you go:
Approaching 65 or already over 65 and wondering how to avoid penalties for not enrolling in Medicare? Here's what you need to know:
- **Employer/Union Coverage (Active Employment):**
- If you or your spouse are actively working and covered by a group health plan with 20+ employees, you can delay enrolling in Medicare Part B and Part D without facing penalties.
- Ensure that your employer/union coverage is considered "creditable" according to Medicare's standards.
- **Special Enrollment Period (SEP):**
- Upon the end of your employment or coverage, you have an 8-month window to enroll in Part B and a 2-month period for Part D to avoid lifelong penalties.
- **Documentation:**
- Maintain records of your creditable coverage, such as letters from insurers, in case Medicare requires verification.
- **Exceptions:**
- Note that Marketplace plans (ACA), retiree plans, or COBRA do not qualify as creditable coverage. Enroll in Medicare at 65 to steer clear of penalties under these circumstances.
Remember the penalty risks:
- Part B: A 10% monthly premium increase for every 12-month delay in enrollment.
- Part D: A 1% monthly premium penalty for each month without creditable drug coverage.
For personalized guidance, always consult Medicare (1-800-MEDICARE) or a licensed advisor to ensure you navigate your Medicare enrollment without incurring penalties.
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