Dear Toni: My husband, Jason, is a retired veteran and never enrolled in Medicare because he uses the VA for his medical care and does not have to pay the Medicare premium.
He is having heart issues and wants to go to a local cardiologist. The doctor’s office advised him to enroll in Medicare since they will not bill the VA facility and are not in the VA’s Community Care program.
Social Security told him that he must pay more to enroll in Medicare Part B since he never enrolled when he turned 65 in 2016.
Is there a way that he can take Medicare Part B without having to pay the extra penalty? — Marsha, Lake Charles, La.
Dear Marsha: Since Jason did not enroll in Medicare when he first turned 65 and is no longer working with full employer benefits, he will receive a penalty when he enrolls in Medicare Part B during the general enrollment period (Jan. 1 to March 31).
His late enrollment penalty will be 10 percent for each 12-month period that he could have had Part B but did not sign up. For 10 full years, that equates to an extra 120 percent each month for the rest of his Medicare life.
For 2026, Jason’s Medicare Part B penalty would be $243.48, plus the Part B premium of $202.90.
If he decides to enroll in Medicare Parts A and B during this year’s general enrollment period, the following rules will apply:
Supplemental coverage: There is a six-month open enrollment period beginning the first month you’re enrolled in Part B to sign up for a Medicare supplemental policy without having to answer health questions. After six months, complete underwriting is required.
Advantage plan: You can get a Medicare Advantage plan with or without prescription drug coverage. With a Medicare Advantage plan there are no health questions, but you may have to pay more. You must have both Parts A and B to join a Medicare Advantage plan. Coverage starts the first day of the month after you sign up.
Part D drug plan: Medicare considers the VA “creditable” coverage, so veterans are able to keep using the VA for prescriptions without incurring a penalty if they sign up for a Part D plan later on.
If the Medicare premium with a penalty is too high, Marsha, I would recommend that Jason remain with the VA medical facility for his care and not pay the Medicare premium. Begin exploring non-VA medical care options by contacting his local facility and asking for referrals to providers who accept VA benefits.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.
