Penalty for Delaying Medicare Sign-up

Q. I get my medical coverage from the Veterans Administration because of post-traumatic stress disorder. I have Medicare Part B insurance, but the VA does not bill Medicare. Should I continue having the cost of Medicare Part B taken out of my Social Security check?

A. This is a personal decision, one that only you can make. But before you make any choice, you need to fully understand the potential consequences of terminating your Medicare Part B coverage.

For example, if you drop Medicare and then need to use health care providers outside the VA system — suppose you're taken to a non-VA hospital in an emergency — you will have to pay the bills yourself. Moreover, even though the VA cannot bill Medicare, it can bill any Medicare supplemental health insurance (medigap) coverage that you might have for Medicare-covered conditions. That coverage could be valuable.

Also, if you later change your mind about Medicare and want to re-enroll, you will have to pay a penalty to get back in. Your monthly premium will increase 10 percent for each 12-month period you were eligible but not enrolled.

Help with your decision is available from both Social Security at 1-800-772-1213 and from the VA Health Benefits office at 1-877-222-8387. Both offices will probably tell you to look before you leap.

Stan Hinden, a former columnist for the Washington Post, wrote How to Retire Happy: The 12 Most Important Decisions You Must Make Before You Retire. Have a question for the Social Security Mailbox? Check out the archive. If you don't find your answer there, send a query.