“So, I enrolled in a Qualified Health Plan through the Health Insurance Marketplace like I was supposed to a few years ago. The premiums were pretty affordable because I qualified for a premium tax credit, and the benefits were great because I qualified for cost share reduction. When my 65th birthday rolled around, I figured I’d just keep the plan I had because it was pretty dang good. And now I find out that because I missed my Medicare Part B enrollment I would be stuck with a penalty??? Help – how do I fix this?”

In general, an individual will not benefit from having a qualified health plan and Medicare at the same time. Confusion about qualified health plans and enrolling in Medicare leads some individuals to make enrollment mistakes. If you stayed on your Marketplace health plan after you turned 65, delaying enrollment into Medicare Part B, generally your only option would be to pick up Part B coverage during the annual General Enrollment Period (GEP) – and face a potential Part B late enrollment penalty – between January 1st and March 31st, with coverage starting the following July 1st. The late enrollment penalty (LEP) can increase your Part B premium (normally $105-$134, on average) as much as 10% for each full 12-month period that you could’ve had Part B, but didn’t sign up for it. So now what do you do? Pay the penalty?

Medicare is offering a one-time, Time-limited Equitable Relief program for enrolling in Part B. The opportunity to request time-limited equitable relief lasts until September 30, 2017. This time-limited equitable relief will
1.) let a beneficiary enroll in Medicare Part B without penalty, or
2.) eliminate a beneficiary’s Part B late enrollment penalty (LEP) if they are already enrolled in Part B but delayed enrollment so that they could stay in their Qualified Health Plan (Marketplace plan).

There are certain criteria a beneficiary must meet in order to qualify for this time-limited equitable relief. Contact the Social Security Administration at 800-772-1213 or go to www.ssa.gov to find a local Social Security office that they can visit in person.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Mediare.gov or 800-MEDICARE to get information on all of your options.