How Equitable Relief Can Help With Your Part B Late Enrollment Penalty
Did you make an enrollment mistake because of an official’s error? Skip Part B enrollment because you had a private insurance plan? There may be options.
Reviewed by: Brett Braithwaite, Licensed Insurance Agent. Written by: Aaron Garcia.
Equitable Relief can reduce or eliminate your Medicare Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive. late enrollment period if you qualify.
Customers who received incorrect guidance from an official or who had Marketplace coverageThe Health Insurance Marketplace is a virtual space where you can shop and enroll in health insurance. Marketplaces can be run by the government, your state or private companies. Marketplaces can be accessed online, by phone, or in-person. may apply for Equitable Assistance.
Proper documentation is critical to a successful Equitable Relief request.
Equitable Relief is when the Medicare system decides to cut you a break on your Medicare Part B enrollment. Under certain circumstances, you may be able to:
- Enroll in Medicare retroactively.
- Avoid or reduce your Medicare Part B late enrollment penalty.
What are those scenarios?
You had Marketplace coverage
If you’re Medicare-eligible and enrolled in Part A, you may be able to delay enrolling in Medicare Part B and stay in your current Marketplace plan. If so, the Medicare system may still apply a late enrollment penalty when you do decide to enroll in Part B. If this happens, using Equitable Relief may reverse or reduce that penalty.  These applications are case-by-case.
You received incorrect information from a Medicare representative
If you get incorrect information from a Social Security or Medicare representative, that guidance could cost you — especially if it causes you to sign up late. If this happens to you, you may file for Equitable Relief.  Unfortunately, you won’t be eligible if the information you receive is from friends or family members.
If you think you’re eligible for Equitable Relief for one of these reasons, you’ll need to contact Social Security. Each of these scenarios will require different actions on your part. For example:
- If you had Marketplace coverage: You’ll need to enroll in Part B through Medicare and request a reduction or elimination of your late enrollment penalty. Make sure to have proof of your Marketplace coverage during the time in question.
- If you received incorrect information, you’d need to document who you spoke to, when you spoke to them and what was the outcome. Also include the result you’re hoping for.
If your Equitable Relief decides in your favor, you receive retroactive coverage, and you pay the monthly premiums you now qualify for.
For example: If you’re granted retroactive coverage in June for May and April, and your monthly premium is $200, you’ll need to pay $400 for those two months, in addition to your payment for June.
When will my Equitable Relief request be decided?
Social Security doesn’t have a formal deadline for deciding Equitable Relief requests, and it’s not required to announce its decision. That means it’s up to you to follow-up on your request and the decision.
Are there other reasons for Equitable Relief?
Yes — the government may grant Equitable Relief windows when certain events that make it more difficult to sign up. For example, special exceptions were made in response to the COVID-19 pandemic, as many were forced to delay vital Medicare enrollment decisions.