Final Rule for Part B Enrollment Changes

Section 120 of the CAA – Beneficiary Enrollment Simplification

In general, under current rules for Medicare premium Part A and Part B, the date when an individual’s coverage becomes effective depends on when they enroll:

  • If an individual enrolls during any of the first three months of their Initial Enrollment Period (IEP), their coverage will start the first month of eligibility (e.g., age 65).
  • If an individual enrolls during their IEP in the month they become eligible, their coverage will start the month after they enroll.
  • If an individual enrolls during any of the last three months of their IEP, their coverage will start 2-3 months after they enroll.
  • If an individual enrolls during the General Enrollment Period (GEP), which runs from January 1st through March 31st every year, their coverage will start July 1st.

But I understand the current rules.
 
I've got a guy who is 76, uses VA coverage, and now wants into one of my incredibly cool civilian MAPD plans. (I have not tried to talk him into this -- our buddy Joe Namath has.) But he's never enrolled in Part B.

I seem to remember that I read somewhere that VA is not creditable for Part B LEP purposes. If that's the case, this fellow is looking at something like a 100% penalty, around $330/mo total premium, which he cannot afford. Thus far I've told him to keep using the VA until I come up with something better.

Anyone able to confirm whether I am thinking correctly on this?
 
Enrollment in the VA health care system is considered creditable coverage for Medicare Part D purposes. This means VA prescription drug coverage is at least as good as the Medicare Part D coverage. Since only Veterans can enroll in the VA health care system, dependents and family members do not receive "credible" coverage under the Veteran’s enrollment. . . . Perhaps it is INcredible coverage?

Under Medicare Part B, VA health care is NOT creditable coverage. Creditable coverage under Medicare Part B can only be provided through an employer. Although a Veteran may avoid the late enrollment penalty for Medicare Part D by citing VA health care enrollment, that enrollment would not help the Veteran avoid the late enrollment penalty for Part B.

[EXTERNAL LINK] - VA and Other Health Insurance - Health Benefits.

Google is your friend . . .
 
I've got a guy who is 76, uses VA coverage, and now wants into one of my incredibly cool civilian MAPD plans. (I have not tried to talk him into this -- our buddy Joe Namath has.) But he's never enrolled in Part B.

I seem to remember that I read somewhere that VA is not creditable for Part B LEP purposes. If that's the case, this fellow is looking at something like a 100% penalty, around $330/mo total premium, which he cannot afford. Thus far I've told him to keep using the VA until I come up with something better.

Anyone able to confirm whether I am thinking correctly on this?

The only way to avoid the part b penalty is if he qualifies for partial or full Medicaid then it will be waived . He has to make around $1450-$1500 max or less a month to qualify . I’ve helped several veterans get it .
 
Enrollment in the VA health care system is considered creditable coverage for Medicare Part D purposes. This means VA prescription drug coverage is at least as good as the Medicare Part D coverage. Since only Veterans can enroll in the VA health care system, dependents and family members do not receive "credible" coverage under the Veteran’s enrollment. . . . Perhaps it is INcredible coverage?

Under Medicare Part B, VA health care is NOT creditable coverage. Creditable coverage under Medicare Part B can only be provided through an employer. Although a Veteran may avoid the late enrollment penalty for Medicare Part D by citing VA health care enrollment, that enrollment would not help the Veteran avoid the late enrollment penalty for Part B.

[EXTERNAL LINK] - VA and Other Health Insurance - Health Benefits.

Google is your friend . . .

Yup, was kinda hoping there might be some workaround I haven't thought of. Thanks for that.

I actually heard a carrier bigwig refer to "credible" (believable?) coverage once. You expect that mispronunciation or misspelling from the uneducated, but not them.

And one small correction -- google isn't your friend. They track you. Duckduckgo is a better friend. :1cool:
 
The only way to avoid the part b penalty is if he qualifies for partial or full Medicaid then it will be waived . He has to make around $1450-$1500 max or less a month to qualify . I’ve helped several veterans get it .

Yes, thanks Don. Unfortunately he can't even qualify for LIS, much less a level of MSP.
 

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