26/08/2025
If it's time for Medicare, make sure you do it right. Answers to a few questions are in our weekly Toni Says column.
For your convenience, here is this week's article.
America’s “What if” Medicare questions answered
This week’s Medicare column consists of “What if” Medicare questions from Toni Says readers around the United States.
1. “What if” I did not enroll in Medicare Parts A and B when I should have, because I do not want to pay that extra Part B premium each month? I do not go to the doctor or take any prescriptions. Can I enroll later? Toni Says: If you are past 65 years and 90 days old, not working full-time with employer benefits and decide to enroll in Medicare Part B, then you will have a big Medicare problem. You must wait until Medicare’s General Enrollment Period (GEP), from January 1- March 31 each year, to enroll. You will receive the Medicare Part B penalty, which is a 10% increase in your Part B premium for each 12-month period that you could have had Part B. Say you wait 3 years; you will pay a 30% penalty. You will pay this late enrollment penalty for as long as you are on Medicare Part B. But with no Medicare Part B, you will have to pay 100% out of pocket for doctor’s care, whether for an office visit or surgery, and any outpatient care, including MRIs, radiation, chemotherapy, X-rays, etc.
Readers, please enroll in Part B at the right time! Don’t wait to enroll when you are past 65 and not working full-time with employer benefits or you will pay the price.
2. “What if” I am past 65, am retiring with employer health insurance and need to enroll in Medicare Part B? What do I do? Toni Says: When you’re retiring or have been laid off past age 65, we advise Toni Says® clients to have their employer sign the Request for Employment Information, form CMS-L564, and attach it to your Application for Employment in Medicare Part B, form CMS-40B. Take both forms to your local Social Security office to enroll in Medicare Part B as quickly as possible. (Chapter 1 of my Medicare Survival Guide Advanced edition explains enrolling in Medicare in detail. Visit www.tonisays.com for more information)
3. “What if” I did not enroll in a Medicare Part D plan when I turned 65 and now am taking an expensive medication? When can I enroll in a Part D plan? Toni Says: If you fail to enroll in a Medicare Part D plan at the right time, then Medicare’s Annual Enrollment (AEP), from October 15 to December 7 each year, is when you can enroll in a stand-alone Part D plan or a Medicare Advantage plan with a Part D plan. The new plan will begin January 1, with you receiving a Medicare Part D penalty for not enrolling at the proper time. (For help with prescription drug planning, contact the Toni Says Medicare team at [email protected] or call 832-519-8664.)
4. “What if” I am on a limited income and cannot afford my Part B premium or prescription drug cost? Toni Says: Contact or visit the state-specific Medicaid office and see if you qualify for Medicaid’s Qualified Medicare Beneficiary (QMB) program or Specified Low-Income Medicare Beneficiary (SLMB) program. Call your local Social Security office or apply online at www.ssa.gov/medicare/part-d-extra-help if you have a limited income and did not qualify for Medicaid. Each year the income qualifications change. The worst Medicaid or Social Security can say about qualifying for extra financial help is no.
Readers, remember… with Medicare, it’s what you don’t know that will HURT you! Need help with your Medicare “what if” question. Contact the Toni Says Medicare team at [email protected] for your answer.
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Toni King is an author and columnist on Medicare, Social Security, and Long-Term Care issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email [email protected] or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.
