Problem:

Mr. S had health insurance under his wife’s retiree group health plan.

Mr. S enrolled in Medicare Part A when he turned 65 and was told by an 800-MEDICARE representative that he did not need to enroll in Part B at that time since his wife’s retiree plan sufficiently covered his needs. He assumed he could enroll in Part B without penalty when and if his wife’s retiree coverage ended.

When his wife’s retiree coverage ended, he tried to enroll in Part B. Social Security informed him that he would have to wait to enroll between January and March during the General Enrollment Period and be without Part B coverage until the following July. He would also have to pay a premium penalty for late enrollment.

What To Do:

Mr. S visited his local Social Security office and learned that people eligible for Medicare are allowed to delay enrollment without penalty only if their health care coverage was provided by a current employer under a group health plan. Since his wife was covered by a retiree plan, he could not delay enrollment or waive the premium penalty. Mr. S explained to the Social Security representative that he spoke to a Medicare representative who told him he did not need to take Part B. The representative advised Mr. S to seek Equitable Relief.

Mr. S wrote to Social Security and explained that he relied on misleading information from Medicare. Because Mr. S had relied on misinformation from the government, Social Security allowed Mr. S to enroll in Part B without being subject to a Part B premium penalty and without regard to enrollment periods.

For more information on when to enroll into Medicare Part B, please click here.

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