UNITED STATES─ Hello Ms. Toni: I am a Vet and have always received my healthcare from the Michael DeBakey VA center. I turned 65 last April 2019 and did not sign up for Part B in Medicare.
Now, I have a serious heart condition requiring surgery and I would like to go to a heart specialist outside of the VA, but I have been told I will have to pay 100 percent for doctor care, MRIs, etc. since I do not have Part B. I know I need to enroll in Part B, but really do not know what to do. Can you help me? Sam, a Marine from Bellaire.
Sam: It is my honor to help Veterans understand their Medicare options! I am glad you asked about what you should do because now is Medicare’s General Enrollment Period which is from January 1- March 31 and your Medicare Part B will begin July 1.
To qualify for Medicare, one must work and pay taxes for 10 years or 40 quarters and received Medicare Part A at no cost. If you did not work enough quarters, then one can qualify for Medicare if their working spouse has enough quarters.
First, you need to go to your local office in person to enroll in Part B and tell the Social Security Rep that you need to enroll in Part B under the “General Enrollment Period.” You can call Social Security at 1-800-772-1213 and discuss this issue, but I would advise you to visit your local Social Security office and apply ASAP because the enrollment time ends on March 31.
Because you did not enroll in Part B when you were first eligible for Medicare, you may have to pay a “late enrollment” penalty of 10 percent for each full 12-month period that you could have had Part B, but did not sign up for it.
The most important thing to remember about delaying Part B of Medicare is the 10 percent penalty for each full 12-month period. This penalty is for anyone who did not enroll in Medicare Part B properly when first eligible. Let’s says you waited 50 months, which is a 4 full 12-month period, then the Part B penalty is an additional 40 percent added to the current Part B premium for as long as you have Medicare.
As you are aware Sam, no one ever knows when they will need to receive healthcare outside of the VA Centers anywhere nationwide. Now you know why it is so important to enroll in Medicare Part B whether you are a Veteran who uses to VA or someone who only has Medicare and needs serious medical needs or is healthy.
Medicare Part A covers inpatient hospital and skilled nursing care and Medicare Part B covers all outpatient needs, doctor services such as office visits and even surgery, MRIs, chemotherapy and the list can go on. Without Medicare Part B, a person can have to pay 100 percent out their pocket which could be in the thousands or hundreds of thousands of dollars.
Bottom line…enroll in Part B when you are tuning 65 when not working full-time with true employer benefits or covered under a working spouse’s employer benefits.
For questions regarding the maze of Medicare, call the Toni Says® Medicare hotline at 832-519-8664.
Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the Medicare Survival Guide® Advanced book to the Toni Says Medicare column readers at www.tonisays.com.