If you have been unable to enroll in Medicare since the start of 2022 because of problems with the Social Security Administration’s phone system, you can ask for extra time to sign up — even if your initial enrollment, special enrollment or general enrollment periods have passed.
To enroll using this special “equitable relief,” visit a Social Security office or call 800-772-1213 to let workers know about the trouble you have had. For help with your options, you also can contact your State Health Insurance Assistance Program (SHIP) center.
“Social Security didn’t reopen their offices for walk-in appointments until early April, so people without internet access who couldn’t get through to Social Security over the phone had no recourse,” says Elizabeth Goodsitt, a spokeswoman for the Wisconsin Department of Health Services. That state’s SHIP center received many reports of people unable to reach Social Security because of the phone problems.
If you take advantage of this program, you will have until Dec. 30 to enroll in Medicare (Dec. 31 is a Saturday). This additional time is especially important, since the annual general enrollment period, which had been a last-chance option, ended March 31.
Medicare coverage can go back to Jan. 1
If you’ve had doctor or hospital bills during the time you were eligible to be on Medicare, you can request Medicare coverage to start as far back as Jan. 1. The catch: You’ll have to pay all premiums in a lump sum, though the amount can be deducted from any Social Security benefits you’re receiving now.
Most people get Part A free but must pay $170.10 a month for Part B. Single beneficiaries and married couples with higher incomes pay more.
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After receiving retroactive coverage, you can ask your doctor and providers of other services to resubmit the bills to Medicare. Tatiana Fassieux, an education and training specialist with the nonprofit California Health Advocates, said she also helped a man ask Medicare to reimburse providers for medical bills he had already paid. Then the providers would reimburse him.
Signing up with equitable relief may help you avoid late-enrollment penalties related to your initial or special enrollment periods. The time between your failed attempt at enrollment in 2022 and signing up with equitable relief won’t count if you otherwise owe a penalty.
What to watch for with Advantage, Part D, Medigap
Want to sign up for Medicare Advantage or Part D prescription drug coverage? After you’re notified of retroactive Medicare coverage, the Centers for Medicare and Medicaid Services (CMS) will grant you a two-month special enrollment period (SEP) to choose a plan.
Be careful about the timing of retroactive coverage if you want to buy Medicare supplemental insurance, better known as Medigap. This private insurance pays some of your out-of-pocket costs when you choose original Medicare.
If you buy a Medigap policy within six months of enrolling in Medicare Part B, insurers can’t reject you for coverage or charge more because of preexisting conditions. But if you enroll in Medicare retroactively through this equitable relief program, you may lose several months of the Medigap open enrollment period.
Your state may have special rules if you are already past that deadline. Contact your local SHIP center for details.
Kimberly Lankford is a contributing writer who covers personal finance and Medicare. She previously wrote for Kiplinger’s Personal Finance magazine, and her articles have also appeared in U.S. News & World Report, The Washington Post and The Boston Globe. She received the personal finance Best in Business Award from the Society of American Business Editors and Writers.