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It worked for two years. Then his prescriptions went up
A 67-year-old man came to us with a question about his bills. For two years, he thought he had Medicare Advantage. In fact, he only had Original Medicare, with no drug plan. He paid for his prescriptions himself and thought that was normal.
For two years, that worked. Then his prescriptions went up in price, and he came to ask about Part D. That's when we found out he had missed his enrollment deadline. Now he will pay a penalty for life, based on every month he went without a plan.
For two years, that worked. Then his prescriptions went up in price, and he came to ask about Part D. That's when we found out he had missed his enrollment deadline. Now he will pay a penalty for life, based on every month he went without a plan.
"He didn't make a math mistake. He just didn't know he had to make a choice, and that the choice had a deadline."
From our work at the Council for Cross Cultural Affairs
This may be the most common kind of loss. It is not only about the money. It is the feeling that you didn't know: letters arrived, dates passed, and no one explained what they meant.
The short version
Everyone has their own seven-month window around their 65th birthday. If you sign up during this window, you pay no penalty.
If you miss it, you pay an extra charge for life: 10% more on your Part B premium for each full year without Part B, and 1% of the national base premium for Part D for each month without drug coverage.
If you're still working, you can sometimes delay Part B without a penalty. This only works with certain kinds of coverage.
If you miss it, you pay an extra charge for life: 10% more on your Part B premium for each full year without Part B, and 1% of the national base premium for Part D for each month without drug coverage.
If you're still working, you can sometimes delay Part B without a penalty. This only works with certain kinds of coverage.
Your seven-month window
The Initial Enrollment Period starts three months before the month you turn 65, includes that month, and ends three months after it.
Example: You turn 65 in May. Your window opens February 1 and closes August 31.
Your start date depends on when you sign up
Sign up in the three months before your birthday month, and coverage starts on the 1st of your birthday month.
Sign up in your birthday month or later, and coverage starts on the 1st of the month after you sign up.
Sign up in your birthday month or later, and coverage starts on the 1st of the month after you sign up.
In short: if you sign up early, you don't have to wait for coverage.
Note: If your birthday is on the 1st of the month, your window starts and ends one month earlier.
What being late costs
Part B: 10%, for life
Your premium goes up 10% for each full 12-month period when you could have had Part B but didn't. The penalty never ends and does not start over.
Part D: 1% a month, for life
You pay 1% of the national base premium for each month without drug coverage. This happens most often to people who are healthy at 65 and don't take any medicines. The penalty grows every month, and many people only find out about it when they need their first prescription.
All of this is written in your Medicare letters, usually at the bottom of the page in the smallest print.
"It talks about late penalties right here, but who reads it to the end? People read the first three lines, don't understand them, and close it."
From our work at the Council for Cross Cultural Affairs
If you're 65 and still working
At one of our seminars, a woman about 70 years old raised her hand. "Why didn't anyone tell me I didn't have to pay for Part B while I was working? I paid extra for three years." Someone explained it to her. She nodded, stopped for a moment, and said, "So it's not just me."
"That's what we hear most often. People think they're the only ones who got confused, but most people are confused."
Alisa Yurchenko
Executive Director, Council for Cross Cultural Affairs
Can you delay Part B without a penalty?
Yes
You or your spouse are still working and have coverage from a current employer with 20 or more employees. After the job or the coverage ends, you have 8 months to sign up.
No
You have COBRA, retiree coverage from a former employer, only VA benefits, or a Marketplace plan. These don't protect you from the penalty.
Before you delay Part B, ask your employer to confirm in writing that your coverage qualifies.
If you've already missed your deadline
Every year, from January 1 to March 31, there is a General Enrollment Period. If you sign up then, your coverage starts on the 1st of the next month. You will still pay the penalty, but you will have coverage.
If you waited because you had coverage from an employer, tell Social Security. You may have a Special Enrollment Period. If someone from an official office gave you wrong information, ask about "equitable relief."
If you waited because you had coverage from an employer, tell Social Security. You may have a Special Enrollment Period. If someone from an official office gave you wrong information, ask about "equitable relief."
Who we are
The Council for Cross Cultural Affairs is a 501(c)(3) nonprofit in Sacramento. We hold seminars and one-on-one meetings. We don't sell insurance, and we don't give legal advice. We explain how things work. We answer the questions people feel embarrassed to ask because they think, "I'm an adult. I should understand this."
We hold free seminars on Medicare and Medi-Cal. We explain how the system works in simple words, go through real letters, and answer questions. Some people sign up on their own. Some come with their children. Some come with a neighbor just for company, and then the neighbor asks the best questions.
To learn about the next seminar, call (916) 483-5454.
How the free consultation works
Step 1
Fill out the form or call (916) 483-5454. We'll call you back within one business day to set up a time that works for you. We can meet by phone, by video, or in person in Sacramento.
Step 2
We look at your situation together: your age and deadlines, your doctors, your prescriptions, and whether you have Medi-Cal or insurance through work. You can bring the letters you don't understand, and you can bring your children.
Step 3
You leave with a clear plan: what to sign up for, when to do it, and where to go. The decision is always yours.
Why is it free? We're a nonprofit, and explaining these programs is our mission. We don't charge for consultations or seminars, and you don't owe us anything after we talk.
Book a free consultation
Leave your name and phone number. We'll call you back and answer your questions.
Prefer to call? (916) 483-5454
Important:
Never give personal information over the phone to people you don't know.
Never give personal information over the phone to people you don't know.
Important: Never give personal information over the phone to people you don't know.
Never sign anything a stranger sends you by mail. There is a lot of fraud around Medicare and Medi-Cal right now.
Questions people ask us
When is the best time to sign up for Medicare?
In the three months before the month you turn 65. Then your coverage starts on the first day of your birthday month, with no waiting and no penalty.
I don't take any medicines. Do I need Part D?
Usually yes, unless you have other drug coverage that qualifies. The penalty grows each month you go without coverage, even if you don't need a prescription yet.
Does COBRA count as employer coverage?
No. This mistake costs people the most money. With COBRA, you can't delay Part B.
Can the penalty be removed?
Usually, no. It stays for as long as you have that coverage. There are exceptions if an official source gave you wrong information or you had qualifying coverage, so it's worth checking your situation.
Does signing up cost money?
No. Signing up is free.
Is your consultation really free?
Yes. We're a nonprofit, and we don't charge for consultations or seminars.
Do you hold seminars?
Yes. Our seminars are free. To learn about upcoming seminars and register, please call (916) 483-5454. Consultations in other languages are available upon request.