Part B enrollment, ICEP timing issue

[beachbum2012]

Prospect is T65 in January. She's working thru some issues where she's within a quarter or 2 from having 40 and qualifying for premium-free Part A. To further complicate it, one of her employers hasn't been taking out FICA (unaware to her) which made her not eligible for recent quarters to qualify. She's working with the IRS to pay those back taxes and get those quarters to qualify.

But the real issue with my question is timing. If she doesn't sign up for Medicare until March or April, then Part B wouldn't start until June or July 1. This means her ICEP would expire at the end of April and she wouldn't be able to sign up for a MAPD since Part B wouldn't be effective yet.

1st question is: am I understanding right that she has to sign up for a MAPD by the end of April no matter when Part B starts? Or am I possibly not understanding the ICEP/IEP rules right where she might have more time if Part B would start in June or July? She would not qualify for any SEPs.

2nd question is: even if she waits to sign up for Medicare until March to avoid paying a Part A premium, don't they back-date Part A to your birth month anyway? Would Social Security then charge her for those months of Part A premium if she hasn't gotten her 40 quarters in by then?

 

[Hopes]

I believe that if she goes ahead and starts Part A in January and takes Part B in March, her start date for Pt B would be June 1.

When will my coverage start? | Medicare

Which means you can use ICEP during the 3 months prior to the Pt B effective date, for a June 1 plan effective date.




In the above link, it appears the start time for Part A is different depending on whether or not it is premium free or if you have to buy so I'm curious as to how this would play out.

Does she have any kind of group coverage now?

 

[beachbum2012]

I believe that if she goes ahead and starts Part A in January and takes Part B in March, her start date for Pt B would be June 1.

When will my coverage start? | Medicare

Which means you can use ICEP during the 3 months prior to the Pt B effective date, for a June 1 plan effective date.

View attachment 4883


In the above link, it appears the start time for Part A is different depending on whether or not it is premium free or if you have to buy so I'm curious as to how this would play out.

Does she have any kind of group coverage now?

For point 2) in the graphic, it's not a typical delay "Part B while you're working, and sign up later using an SEP". It's still all within her IEP. So, if her Part B effective date is June, I'm not confident she can still sign up in May for a June effective date. It's tricky.

She has no coverage now.

 

[beachbum2012]

Ok, so she plans on signing up for Part B this month, this week in fact. As far as I understand it, that would make her Part A effective 1-1-19 and Part B will be effective 7-1-19.

It sounds like she can enroll in a MAPD anytime between now and 6/30 to be effective 7/1. But if she does this, will she have a LEP? She has no other drug coverage now.

If she will have a LEP, what's the best way to avoid it? Enroll in a PDP by the end of the month? She'd have to wait until July for a medsupp to start.

There don't seem to be any clear cut rules for those who wait until the back end of their IEP to enroll in Part B and aren't covered at work.

 

[Chazm]

She can’t avoid LEP unless she qualifies for LIS.
I would stop trying to find “ways out” for her. She made her bed.

 

[jbage007]

What Chazm said.
Too many people trying to scam the system one way or another.
Our job is not to babysit.

 

[J2727]

Ok, so she plans on signing up for Part B this month, this week in fact. As far as I understand it, that would make her Part A effective 1-1-19 and Part B will be effective 7-1-19.

It sounds like she can enroll in a MAPD anytime between now and 6/30 to be effective 7/1. But if she does this, will she have a LEP? She has no other drug coverage now.

If she will have a LEP, what's the best way to avoid it? Enroll in a PDP by the end of the month? She'd have to wait until July for a medsupp to start.

There don't seem to be any clear cut rules for those who wait until the back end of their IEP to enroll in Part B and aren't covered at work.

You're confusing different enrollment periods.
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She is T65 January 2019, so she's in her IEP and ICEP (#1) - Oct (2018), Nov, Dec, Jan, Feb, Mar, April (2019).

Her IEP and ICEP (#1) supersede and come before every other enrollment period.
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The GEP doesn't apply since she's in her IEP and ICEP (#1).

ICEP #2 doesn't apply because she's not getting Part B during the GEP or getting Part B due to losing creditable coverage.
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No point in delaying Part A or B.
Enroll in both now.
Once she has enough credits to get Part A premium-free, she can file an appeal.

Enrolling in Part A/B:
- before her birth month (months 1 - 3) starts coverage her birth month
- on her birth month (month 4) starts coverage the next month
- 1 month after her birth month (month 5) starts coverage 2 months later
- 2 months after her birth month (month 6) starts coverage 3 months later
- 3 months after her birth month (month 7) starts coverage 3 months later
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Her MedSupp OEP lasts 6 months after Part B starts, although carriers allow you to enroll a client prior.

Enrolling before Part B has coverage starting at the same time as Part B. Enrolling after Part B will start coverage the next month.
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If she wants a MAPD or just a PDP, she needs to use her IEP.
If she wants MA only, she needs to use her ICEP (#1).

If she enrolls the 3 months before her birth month, coverage starts her birth month. Enrolling during her birth month or one of the 3 months after, coverage starts 1 month later.

 

[somarco]

one of her employers hasn't been taking out FICA (unaware to her)

How can she not know? Does she not look at her pay stub?

If her employer is not withholding FICA/Medicare taxes there may be some employer issues with the DOL. Was/is she W-2 or 1099?