Beginner’s Corner

Situation: Person fills in form, sends zip code and mm/yyyy of birth.

Simple Form

Responder: Zip code 88901 (modified), 03/1956
Me: What Medicare plans do you have (Medigap/Part D/Medicare Advantage)?
Responder: None other than Part A and Part B

Late Enrollment Penalty Has Begun

For the Responder, the Part D Late Enrollment Penalty begins 3 months after the end of March 2021, so July – December 2021, a total of 6 months.
The penalty will be equal to: 6 times the national average (0.34), rounded to the nearest $0.10. The CMS is keeping track of this.
We cannot do anything to fix this unless the Responder qualifies for Extra Help.

We Continue

Me: Do you realize that you have unlimited financial exposure if you have large healthcare costs? Reason: Part A and Part B have NO out-of-pocket maximum limit.
Responder: We will address this when I have an income.
Me: There are plans that have NO additional premium (must have Part A and Part B), but these plans MUST INCLUDE an out-of-pocket limitation so you are protected.
Responder: What’s the next step?

This is exactly the right response, the light has flickered from entirely “off” to “on.”

Takeaway: This Happens is the name of the anecdotes throughout my favorite book (on Medicare), ahem. This person is NOT ALONE, and this conversation will stop the Part D Late Enrollment Penalty from increasing, and put a limit on his out-of-pocket financial obligations if healthcare services are required. For no extra premium. That’s the big picture, the details are miniscule in comparison: get the big stuff right.

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