Can I appeal a Medicare penalty and what do I need to prove?

Medicare has late enrollment penalties for Part B and Part D that can add up over time. Part B penalties add 10 percent to your premium for each 12-month period you went without coverage when you were eligible. Part D penalties add about 1 percent per month. These penalties follow you for as long as you have Medicare, which makes them painful. You can appeal a penalty by requesting a reconsideration from Medicare or the Social Security Administration, depending on which penalty you are dealing with. To have a realistic shot, you generally need to show one of two things. Either you had qualifying coverage elsewhere, such as employer insurance based on active work, that made enrollment unnecessary, or you were given incorrect information by a government agency and relied on that bad advice to your detriment. The second path, sometimes called equitable relief, is harder to win but not impossible. You will need documentation. That means letters, written communications, notes from phone calls with dates and representative names, and anything else that supports your account of what happened. Simply not knowing about the deadline is usually not enough. If your situation is complicated, working with a licensed Medicare counselor before you file can help you present the strongest possible case.

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