ArcaMax

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 that he enroll in Medicare since this office will not bill the VA facility and is 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 about 10 years ago in 2016.

After reading your Medicare articles in our local newspaper, we need your guidance. Is there a way that he can take Part B without having to pay the extra penalty? Thank you, Toni.

—Marsha from Lake Charles, La.

Hello, Marsha:

Since Jason did not enroll in Medicare when he first turned 65 and is no longer working with full employer benefits, I’m afraid he will receive the Part B late enrollment penalty when he enrolls in Medicare Part B during Medicare’s General Enrollment Period from Jan. 1 to March 31. No one ever knows when they will need to receive health care outside of a Veterans Administration Center.

Now is the time for him to enroll in both parts of Medicare, Part A and Part B. He did not enroll in Part B when he was first eligible in 2016, and his “late enrollment” penalty is 10% for each 12-month period that he could have had Part B but did not sign up for it. His penalty will be for 10 full years, or an extra 120% each month for the rest of his Medicare life.

For 2026, Jason’s Medicare Part B penalty will be 120% times $202.90, or an extra $243.48, plus the Part B premium of $202.90, which totals $446.38 per month. (Chapter 1 of the Medicare Survival Guide Advanced edition explains the rules of enrolling in Medicare the right way, especially for those with veterans’ benefits.)

If he decides to enroll in Medicare Parts A and B for the first time during the 2026 Medicare General Enrollment Period, which will end on March 31, the following Medicare enrollment rules will apply:

—Medicare Supplement Insurance: There is a six-month open enrollment period beginning the first month you’re enrolled in Part B during which the Medicare enrollee will not have to answer health questions for underwriting. After six months, complete underwriting is required.

—Medicare Advantage Plan: You can get a Medicare Advantage Plan that comes 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 Part A and Part B to join a Medicare Advantage Plan. C overage starts the first day of the month after you sign up.

—Medicare Drug Coverage through a Part D Plan: Medicare considers the VA “creditable” coverage,” so there is a happy ending for Jason in this regard: NOT enrolling in a Medicare Part D Prescription Drug plan with a Medicare Supplement or a Medicare Advantage HMO/PPO is a good possibility. If veterans with VA benefits do enroll in Part D later, they will not receive the Medicare Part D late enrollment penalty since the VA prescription drug plan is creditable. Veterans are able to keep using the VA for prescriptions.

Marsha, I would recommend to Jason that, if the Medicare premium with penalty is too high, he remain with the VA medical facility for his care and not pay the Medicare premium. Begin exploring the non-VA medical care options by contacting the local VA facility and asking for referrals that accept VA benefits outside the local VA medical area.

Remember, with Medicare, what you don’t know WILL hurt you!

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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 info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.

©2026 Toni King. Distributed by Tribune Content Agency, LLC.

Copyright 2026 Toni King, Distributed by Counterpoint Media