Medicare Part B, which covers doctor’s visits, outpatient care, and other preventative medical services, is available to individuals who do not have employer based health insurance and are 65 or older or those who qualify due to a disability. However, people have to sign up for Medicare Part B within certain enrollment windows when they first become eligible for Medicare. Those who do fail to sign up for Medicare Part B within a certain time must then pay a penalty for Medicare Part B coverage in all future years. The penalty increases the more years pass before individuals finally sign up for Part B coverage.

Recently, increasing numbers of people have failed to sign up for Medicare Part B because they thought that plans bought through the Affordable Care Act’s exchange marketplaces eliminated the need to sign up for Medicare Part B. However, this belief is mistaken. Affordable Care Act marketplace plans do not delay eligibility for Medicare Part B. Additionally, once someone becomes eligible for Medicare, they no longer are eligible for the subsidies that may make exchange marketplace plans seem more affordable than Medicare Part B. Even if someone has mistakenly signed up for a marketplace plan, the private insurer cannot unilaterally cancel coverage. Only the subsidies that may have made the plan more affordable get canceled.

In response to this mistaken belief, the Centers for Medicare and Medicaid Services, or CMS, recently announced they will now waive the late enrollment penalty for those who thought that a marketplace plan eliminated their need to sign of for Medicare Part B. However, this waiver must be actively applied for and is only available through September 30, 2017.

Medicare has been issuing emails to some individuals nearing the age of 65 who currently have subsidized marketplace plans and should sign up for Medicare Part B. However, these notices may not reach people over the age of 65 who have already missed their initial Medicare Part B sign-up window or those who do not receive subsidies for marketplace plans.

If you have purchased a marketplace plan and realize that you may be otherwise eligible for Medicare due to age or disability, please call Martha C. Brown & Associates at (314) 962-0186 for help in applying for the waiver to avoid paying permanent penalties for Medicare Part B coverage.