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.
- FAQ Medicare and the Marketplace
- Q: (page 6) Can Medicare beneficiaries with coverage under SHOP plans delay enrollment in Medicare Part B without penalty?
- Yes. A Medicare beneficiary who is enrolled in employer purchased SHOP coverage is treated the same as any other person with employer group health plan coverage [my italics].
- Medicare Part B application, see page 3
- California Health Advocates-delaying enrollment in Part B
- Medicare Interactive: delaying enrollment in Part B
- MedicareRights.org: delaying enrollment in Part B
- Medicare and Other Health Benefits: Your Guide to Who Pays First
- 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. ↩