Can You Get a Medicare Late Penalty Revoked?

Copyright © 2014 AARP. All rights reserved.

Depending on your situation, the answer to the question “Can you get a late penalty revoked?” may be “yes,” “maybe,” or “forget about it.” But you have the right to challenge a penalty that you think has been unfairly imposed, especially if you were given wrong information.

If you get hit with late penalties for Parts A or B, you’ll find out about it when the Social Security Administration sends you a letter. In the case of a Part D late penalty, you’ll receive a letter from the Part D plan or Medicare Advantage plan that you’ve signed up with. Either type of letter gives instructions on how to appeal the decision if you don’t agree with it, together with deadlines for responding.

The government enforces the rules strictly, and being ignorant of them isn’t considered a defense. But you may have a chance if you can show a government official made a mistake or gave you incorrect information that sent you on the wrong track.

Getting slapped with a late penalty because of some regulation you’ve never heard of is bad enough. Getting that penalty because you acted on inaccurate or incomplete information from someone you were confident would know feels a lot worse.

This is not about information from family, friends, doctors, or even employers’ benefits departments — none of whom can be expected to be reliable sources on Medicare’s complexities. And if the misinformation came from them, you can’t do anything about it anyway.

But if misleading information from a government official — whether from Social Security, Medicare, or other government agencies — caused you to miss your enrollment deadline and led to a late penalty, you may be able to get redress under a little-known process called equitable relief.

You’re allowed to apply to Social Security for equitable relief if your failure to sign up on time for Part A, B, or D was due to “error, misrepresentation, or inaction of a federal employee or any person authorized by the federal government to act in its behalf.” (This group includes employees of Part D or Medicare Advantage plans.)

For example, Greg went to his local Social Security office to sign up for Medicare. The official asked if he had insurance from an employer. “I sure do,” Greg replied. But the official didn’t explain that Greg could only delay Part B if he or his wife were still working. So Greg was left thinking, wrongly, that his retiree benefits counted as employer insurance and that he didn’t need to enroll in Part B.

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