Many of our clients decide to keep working after their 65th birthday, and they stay on their employer group health plan delaying Part B until they retire. You likely delayed enrollment because you were on an employer group plan with benefit coverage that was deemed creditable.
In that case, even though you were safe in deferring your enrollment, you may still experience getting a concerning letter from your Medicare Advantage plan or your Part D prescription drug plan. The letter would say that you may be responsible for a late enrollment penalty on your Part D coverage if you didn't have creditable drug coverage. Here is what you need to do.
Don't Panic, But Don't Ignore It
Do not panic; do not throw the packet out, as you will need to reply. Medicare doesn't know you had coverage. A form will typically come with the letter that needs to be filled out stating you were covered under an employer group health plan (or other form of creditable coverage - like the VA). If you don't fill out the form and send it back within the short window of time they give you, they will assume no response means you had no coverage and assess the late enrollment penalty. The penalty can be overturned; however, it is a HUGE headache and takes considerable effort and time!
I know you get a ton of mail from your plan, but do not make the mistake of thinking everything you are receiving is informational in nature—some actionable items, like the late enrollment penalty notification and form, need to be completed.
If you need clarification about any Medicare mail you receive or have questions about how to respond to forms requesting your information or what type of supporting documentation needs to go with it, please call us at 877-220-1089. We are here to provide certainty to your questions. So instead of guessing, contact us for guidance. We are always here to help.
By American Retirement Advisors
American Retirement Advisors helps retirees and pre-retirees navigate Medicare, estate planning, and retirement income — so you can enjoy the retirement you've earned.
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Easy Eddie's Take
The advice here is spot-on, and I see this confusion all the time. When you delay Medicare Part B enrollment because you have creditable coverage through your employer, the Centers for Medicare & Medicaid Services doesn't automatically know about your previous coverage. Most people are surprised when they learn that Medicare Part D prescription drug plans can impose a penalty of 1% of the national base beneficiary premium for each month you were without creditable coverage—and that penalty stays with you as long as you have Part D coverage.
Here's the good news: if you truly had creditable coverage through your employer group health plan, Veterans Affairs, or another qualifying source, you can avoid this penalty entirely by responding to that form promptly. The key is documentation—keep records of your previous coverage dates, and don't wait to respond. Think of it this way: Medicare wants to make sure everyone has continuous prescription drug coverage, but they just need proof that you actually had it. A little preparation today can make a big difference tomorrow.