Medicare questions from Toni Says readers

on Aug 24, 2023

This week’s Toni Says Medicare column consists of “what if” Medicare questions from Toni Says readers around the United States.

Q: What if I did not enroll in a Medicare Part D plan when I turned 65 and I am taking an expensive medication? When can I enroll in a Part D plan?

A: When one fails to enroll in a Medicare Part D plan at the right time, then Medicare’s Annual Enrollment, (from October 15 to December 7 each year) is when you can enroll in a stand-alone Part D plan or a Medicare Advantage plan with a Part D plan. The new plan will begin January 1 with you receiving a Medicare Part D penalty for not enrolling at the proper time. For help with prescription drug planning, contact the Toni Says Medicare team.

Q: What if I am on a limited income and cannot afford my Part B premium or prescription drug cost?

A: Contact or visit the Medicaid office and see if you qualify for Medicaid’s Qualified Medicare Beneficiary (QMB) Program or Specified Low-Income Medicare Beneficiary (SLMB) Program. Call your local Social Security office or apply online for “Extra Help” if you do not qualify for Medicaid. Each year the income qualifications change. The worst Medicaid or Social Security can say regarding qualifying for extra assistance is NO. Get proactive about your Medicare!

Q: What if I did not enroll in Medicare Parts A and B when I should have, because I do not want to pay that extra Part B premium each month? I do not go to the doctor, and I do not take any prescriptions. Can I enroll later?

A: If you are past 65 years and 90 days old, not working full-time with true company benefits, and decide to enroll in Medicare Part B, then you will have a big Medicare problem. You must wait until Medicare’s General Enrollment Period, January 1 – March 31 each year, to enroll. You will receive the “famous” Medicare Part B penalty which is a 10% increase in your Part B premium for each 12-month period that you could have had Part B. Say you wait 3 years; you will pay a 30% penalty. You will pay this late enrollment penalty for as long as you are on Medicare. With no Medicare Part B, you will have to pay 100% out of pocket for doctor care, whether office visit or surgery and any outpatient care, including MRIs, radiation, chemotherapy, X-rays, etc. Readers, please enroll in Part B at the right time!

Q: What if I am past 65, have retired from work with company benefits and need to enroll in Medicare Part B. What do I do?

A: When one is retiring or has been laid off past age 65, we advise Toni Says clients to have their employer sign the “Request for Employment Information” Social Security form CMS-L564 and attached it to your “Application for Employment in Medicare Part B” form CMS-40B. Take both forms to your local Social Security office to enroll in Medicare Part B as quickly as possible. Once you enroll in Medicare Part B, you only have 63 days to get Medicare Prescription Drug Coverage. Don’t wait too long.

Readers, if you need help, contact the Toni Says Medicare Call Center at 832-519-8664 for Medicare planning that meets your specific Medicare needs. Thank you from the Toni Says team for allowing us to help you navigate the maze of Medicare.

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Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Toni’s new book, Maze of Medicare, is now available on www.tonisays.com. Maze of Medicare is the first explanatory book that includes scripture and positive quotes to help relieve the stress and anxiety over transitioning to Medicare.