Part B Eligibility Question

[melmadhav]

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

 

[DS4]

Is this correct?

Yes. Only employer group coverage allows enrollment after your 65th birthday. Plus, he will pay the +10% penalty.

 

[TwoCents]

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.

 

[G.Gordon]

Yep, he screwed himself somehow last year. He'll wait for the GEP.

 

[melmadhav]

OK thanks for the answers, you guys are the best!

 

[foxmfox1]

He must have opted out of Part B, it's automatic unless you decline. At least it was for me.

 

[somarco]

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.

 

[DS4]

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".

 

[somarco]

The insureds line of think 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".

Possibly. But regardless he goes for a year without any outpatient coverage and will pay "full price" for any treatment.

 

[Chazm]

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

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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He must have opted out of Part B, it's automatic unless you decline. At least it was for me.

You were taking SS. If you're not taking it you must sign up for it.