UNITED STATES—Dear Toni, my husband, Jason, is a Vietnam Veteran and never enrolled in Medicare Part B because he uses the VA for his medical care. He is 77 years old and retired when he turned 65 about 12 years ago.

He is having heart issues and wants to go to a local cardiologist that his best friend uses and must now enroll in Medicare for that to happen. Social Security advised Jason, that he must pay more to enroll in Medicare Part B because he never enrolled when he turned 65 in 2011.

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, Christina from Tampa, FL.

Hello Christina: Since Jason did not enroll in Medicare when he first turned 65 and no longer working with “true” employer benefits. The key words are, “is still working.” Jason will get the famous Part B “late enrollment” penalty when he enrolls in Medicare Part B during Medicare’s General Enrollment Period from January 1 to March 31.

Now is the time for Jason 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 2011 and his “late enrollment” penalty is 10 percent for each full 12-month period that he could have had Part B but did not sign up for it. His penalty will be for 12 full years (12-month periods) or an extra 120 percent each month for the rest of his Medicare life.

For 2024, Jason’s Medicare Part B penalty will be 120 percent times $174.70 or an extra $209.60 plus the Part B premium of $174.70, which totals $384.30 per month.

No one ever knows when they will need to receive healthcare outside of a VA Center. (Chapter 1 of the Medicare Survival Guide Advanced edition explains the rules of enrolling in Medicare the right way especially those with Veteran benefits.)

Christina, now you understand the value of enrolling in Medicare when one is turning 65, whether he/she is a Veteran who uses the VA or someone who only has Medicare and will need Medicare insurance.

Since Jason will be enrolled in Medicare Parts A and B for the first time, the Medicare enrollment rules apply:

• Medicare Supplement, which has a 6-month open enrollment period that begins the first month enrolled in Part B when the Medicare enrollee will not have to answer health questions for underwriting. After 6 months, complete underwriting will happen.

• Medicare Advantage Plan (with or without Medicare Part D prescription drug coverage) on page 71 of the 2024 Medicare & You handbook states, “Your coverage starts the first day of the month after you sign up.” You must have both Part A and Part B to join a Medicare Advantage Plan. V MA plans have “extra benefits” for America’s Veterans.

Not enrolling in Part D (Medicare Prescription Drug plan) has a good ending for Jason. Medicare considers the VA as “creditable” coverage” and when veterans with VA benefits enroll in Part D later, they do not get the Medicare Part D Late Enrollment Penalty. There is NO Part D donut hole when receiving prescriptions from the VA and not enrolled in a Medicare Part D plan.

Good News! Jason can remain with the VA, if the premium is too expensive. He can explore his options for non-VA medical care by contacting his local VA and ask for referrals outside his local VA.

Special note to Veterans Scott Deluzio’s “Drive On” podcast on at driveonpodcast.com which is a resource for veterans. His podcast with Toni will air in March. Email your Medicare questions to in**@to******.com or call 832-519-8664.