Medicare From Incapacity Convert at Age 65 To Medicare Retirement

Goodman60 wrote: ↑Fri Sep 06, 2024 2:50 pm
I am concerned in a really uncommon scenario relating to a member of the family who has been disabled for over 30 years and has been receiving Social Safety Incapacity and Medicare Half A. The household owns a small enterprise (lower than 20 workers) and has been in a position to cowl that particular person on their small enterprise group medical insurance as a member of the family and former principal within the enterprise. This was finished as a result of, in accordance 30+ 12 months outdated reminiscence, they have been advised that so long as the disabled particular person has group medical insurance, they’d not need to take Half B and there could be no penalty if and when the opposite well being protection ended. The disabled member of the family will quickly be age 65 and went to a Medicare insurance coverage dealer to see what to do. They have been advised that Medicare may implement a whopping penalty, each month for the remainder of their life, as a result of the “different protection” was not a part of a gaggle of greater than 20. In fact everybody concerned is anxious. The dealer first thought that Medicare “resets” at age 65, and that failure to take Half B years earlier on the onset of incapacity wouldn’t matter. However that dealer checked later with the next up who raised this concern, considering that there will not be a “reset”, solely a report of 30+ years of not claiming Half B with no different protection that has greater than 20 group members. On the Medicare.gov web site, the disabled member of the family can see the employer protection beneath “Different Insurance coverage” and it is listed as “.

A couple of questions:

1. Is it potential that there actually is a “reset” at age 65, when going from Medicare incapacity to Medicare retirement, so any potential penalty from earlier than turns into moot and the claimant is handled like anybody else reaching age 65?

2. If not, will they actually assess a ten% penalty multiplied by 30 years or a 300%+ penalty?

3. Did one thing change from 30+ years in the past that maybe the household ought to have been conscious of? Was the 20 member group factor all the time a factor?

4. Is there an enchantment course of for conditions like this which might be “historic”?

5. Is there extra that we’re lacking right here that anybody can add that can be useful or at the least informative?

Thanks for assist with this.

See the connected hyperlink from the SSA regs relating to this:

When does this particular person flip 65? That is CRUCIAL data.

1. Based on this, even when the particular person was on Half B with a late penalty earlier than age 65, the late penalty stops. See A.3.a

2. No months earlier than age 65 depend towards a late penalty, in different phrases, if the particular person enrolls when they’re speculated to throughout the age 65 Preliminary Enrollment Interval, there could be no late penalty for Half B. See A.3.b–this is no matter how lengthy that they had Half A solely and have been on SSA incapacity. In fact, in the event that they then nonetheless do not enroll in Half B , the late penalty “clock” begins operating.

https://secure.ssa.gov/apps10/poms.nsf/lnx/0601001010