Late Medicare Enrollees Pay a Price, by Lisa Zamosky

Kudos to Lisa’s excellent article in today’s Los Angeles Times describing the tricky nuances of Medicare eligibility and enrollment.  While mostly accurate, even policy wonks sometimes get it wrong, as when Lisa writes “You can’t delay enrollment and avoid the [Part B late enrollment] penalty if you work for a firm with fewer than 20 employees.”

The fact is, there is no Part B penalty1 while a Medicare-eligible person has employer-sponsored coverage, regardless of the number of employees.  Lisa may have been thinking about whether Medicare is primary payor or secondary payor for enrollees of group health plans. For employers with fewer than 20 employers, Medicare is almost always primary, and if the employee does not enroll in Part B they will have no primary coverage! Yikes!!!

Therefore, it’s usually not a good idea to delay enrollment in Part B if your company has fewer than 20 EEs–but not because of any penalty.


Show 1 footnote

  1. If you don’t sign up for Part B when you’re first eligible or if you drop Part B and then get it later, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it.

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Michael Grodsky

Michael Grodsky, AIF, is founder of Artist Insurance Services, providing unbiased education and access to health insurance for Californians. He is a board member for Side Street Projects, a nonprofit artist-run organization, and is an insurance and financial planning specialist for GYST, an artist-run company providing information and technology solutions for artists. Michael’s Health Insurance 101 workshops have been hosted by non-profit organizations throughout Los Angeles County. He leads the ‘Health Insurance 101’ monthly informational workshop at the Cancer Support Community-Benjamin Center.