Many Americans miss their deadline to enroll in Medicare because they mistakenly think that the purchase of insurance on the marketplaces exempts them from Medicare. This belief costs many Medicare recipients thousands of dollars in medical costs. People who qualify for Medicare will lose subsidies in the online exchange plans, and continuing enrollment an exchange plan will not protect them from a permanent Medicare late enrollment penalty. Medicare is temporarily offering a reprieve from late enrollment penalties (LEP) for those who enrolled in the Affordable Care Act after becoming eligible for Medicare.

You may be eligible to request a time-limited equitable relief if you delayed enrolling in Medicare Part B so that you could stay in your health care insurance plan, known as a Qualified Health Plan (QHP). This opportunity to request equitable relief lasts until Sept. 30, 2017.

This equitable relief helps you enroll in Medicare as soon as possible and can erase a late enrollment penalty. If you are eligible, the equitable relief will let you enroll in Medicare Part B without penalty; or eliminate or reduce your Part B late enrollment penalty if you are already enrolled in Part B but delayed enrollment when you had a QHP. If you do not have premium-free Part A, but you are eligible, you can enroll at any time. You must be enrolled in premium-free Part A in order to request equitable relief.

Steps to request equitable relief:

1. Gather appropriate documentation. You will need proof of your QHP enrollment. You may also wish to bring a Part B enrollment form (Form CMS-40B) and your Medicare card. You can also fill out a Part B enrollment form at your Social Security office.

Examples of proof of Qualified Health Plan (QHP) can be:

  • Letter of enrollment in both Medicare and QHP.
  • QHP premium bills and proof of payment.
  • IRS form 1095-A.
  • A Marketplace QHP eligibility determination notice.
  • Receipt from first premium payment (also called a premium binder payment).

2. Call the Social Security Administration at 1-800-772-1213 or go to www.ssa.gov to find a local Social Security office that you can visit in person. 

3. Once at the office or on the phone with a representative, ask to use the time-limited equitable relief to enroll in Part B and/or eliminate your Part B late enrollment penalty. You must mention that you were enrolled in both premium-free Part A and a Marketplace QHP. If you are calling to eliminate a late enrollment penalty, you must specifically request that you want the late enrollment penalty eliminated.

For more information, contact Ruth Anderson-Cole at 301-609-5712.  Citizens with special needs may contact the Maryland Relay Service at 711, or Relay Service TDD: 800-735-2258.