Part B Eligibility Question

Sep 27, 2016

  1. melmadhav
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    melmadhav Expert

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    I have a client that will be 66 this year, he received his part A 10/2015 however he didn't take out part B. Says he doesn't know what happened with the Part b. He was on an ACA plan with a term date of 6/30/2016 due to non-payment. He went to the SS office to enroll in Part B with the hopes of an SEP however they advised he had to wait until 1/1/17-3/31/2017 for a 7/1/17 eff date.

    Is this correct? I thought he would be eligible for an SEP also since he had the ACA until 6/30/16
     
  2. DS4
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    Yes. Only employer group coverage allows enrollment after your 65th birthday. Plus, he will pay the +10% penalty.
     
    DS4, Sep 27, 2016
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  3. TwoCents
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    He probably doesn't have an election to join a PDP, but at the very least he'd want to during AEP to lessen that LEP then he'll have his ICEP to join an MA/MAPD from 4/1 to 6/30 for coverage to start on 7/1 to go with his Part B start.
     
    TwoCents, Sep 27, 2016
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  4. G.Gordon
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    Yep, he screwed himself somehow last year. He'll wait for the GEP.
     
    G.Gordon, Sep 27, 2016
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  5. melmadhav
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    OK thanks for the answers, you guys are the best!
     
  6. foxmfox1
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    He must have opted out of Part B, it's automatic unless you decline. At least it was for me.
     
    foxmfox1, Sep 27, 2016
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  7. somarco
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    somarco That Medicare Expert Guy

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    Part B is optional. If you are receiving SS when you turn 65 you will be automatically enrolled in A & B and can opt out. Otherwise you sign up for A & B or A only at 65.
     
    somarco, Sep 27, 2016
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  8. DS4
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    The insureds line of thinking was probably, "ok, I have to pay for Part B of Medicare, and, I have an ACA plan I'm currently paying for. I'll decline Part B".
     
    Last edited: Sep 27, 2016
    DS4, Sep 27, 2016
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  9. somarco
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    somarco That Medicare Expert Guy

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    Possibly. But regardless he goes for a year without any outpatient coverage and will pay "full price" for any treatment.
     
    somarco, Sep 27, 2016
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  10. Chazm
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    And might want to inform him if he's been receiving any subsidy for his ACA while he was eligible for Medicare. He will owe that money back.

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    You were taking SS. If you're not taking it you must sign up for it.
     
    Chazm, Sep 28, 2016
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