UNITED STATES—Toni: My husband is a Viet Nam Veteran and never enrolled in Medicare Part B because he uses the VA, close to where we live in Michigan for his medical care. He is having to wait for care from the VA for his heart issues and he wants to go to a local cardiologist.
He is 78 years old and retired when he turned 65. Social Security told him that he must pay more to now enroll in Medicare Part B because he never did enroll when he turned 65 in 2009.
Your name was given to us by an AARP rep to help with Robert’s Medicare problem. Is there a way that he can take Part B without having to pay the extra penalty? Thank You, Carole.
Carole: I really do not have good news for Robert because he did not enroll in Medicare Part B when he first turned 65 and was no longer working with “true” employer benefits. The key words are, “still working.” If he enrolls now, during Medicare’s General Enrollment Period (ending March 31) he will get the “famous” Part B “late enrollment” penalty.
Because Robert did not enroll in Part B when he was first eligible for Medicare, his penalty is 10 percent for each 12-month period that he could have had Part B but did not enroll in it. You said that he turned 65 in 2009 which is 13 full 12-month periods, so that is a penalty of 13 years times 10 percent, each month for the rest of his Medicare life.
For 2023, his Medicare Part B penalty will be 13 times $16.49 (10 percent of the 2023 Part B monthly premium of $164.90) — an extra $214.37. So, Robert’s total Medicare Part B premium for 2023 will be $379.27 per month. (Chapter 1 of the Medicare Survival Guide Advanced edition explains the rules of enrolling in Medicare the right way especially those with Veteran benefits).
No one can anticipate when they will need to receive healthcare outside of a VA Center. Now, you understand the value of enrolling Robert in Medicare Part B when he turned 65, whether he is a Veteran who uses the VA or someone who only has Medicare and needs serious medical needs.
Part B covers your outpatient needs, doctor services such as office visits and even doctor performing surgery, MRIs, chemotherapy, durable medical equipment such as wheelchairs and walkers. and the list goes on. Without Part B of Medicare, a person may have to pay 100 percent out of their pocket for Medicare Part B covered medical care and this care could be in the hundreds of thousands of dollars.
But I do have some good news, Carol. Not enrolling in Part D (Medicare Prescription Drug plan) is another story. Medicare considers the VA as “creditable” coverage. When you enroll in Part D after age 65, you do not get the late Medicare Part D enrollment penalty… Guess what? There is NO Part D donut hole when receiving prescriptions from the VA!! That is a good thing for America’s Veterans on Medicare!
Carole, my advice to Robert is to continue to receive his medical care through the VA, since the penalty may cost him an expensive Medicare Part B premium. Given his heart issues (or if he has other health problems), if Robert ever finds the VA drug formulary does not meet his needs, he can investigate Medicare Part D coverage.
Toni King is the author of the Medicare Survival Guide Advanced edition available at www.tonisays.com. For a Medicare checkup, email email@example.com or call 832-519-8664. Visit www.seniorresource.com/medicare-moments to listen to Toni’s Medicare Moments podcasts and get other information for boomers/seniors.