ORLANDO, Fla. — Physicians and medical students at the Interim Meeting of the American Medical Association (AMA) House of Delegates urged the federal government today to clarify the process of signing up for Medicare so seniors can avoid onerous penalties that can burden them for years.

The resolution calls for Medicare to create a comprehensive checklist for seniors approaching age 65 to facilitate Medicare enrollment and avoid gaps in insurance coverage or permanent increases in premiums. The resolution says the AMA will urge the Centers for Medicare & Medicaid Services to create this checklist and educate seniors about late-enrollment penalties.

Millions of people pay Medicare late-enrollment penalties each month—in addition to their regular premiums— because they missed key enrollment deadlines. About 2.5 million people paid late-enrollment penalties for Medicare Part D in 2022 while nearly 800,000 people paid the late penalties for Medicare Part B in 2021.

“These late-enrolment penalties levy a heavy financial burden on Medicare patients for the rest of their lives – often at a time when they can least afford it. These penalties are the result of patients being unaware of timelines. Medicare’s complexity should not result in a lifetime penalty,” said Toluwalese Ajayi, M.D., a member of the AMA’s Board of Trustees.  “We must ensure that all patients, especially vulnerable populations, have the information needed to make informed decision about their health care.” 

Medicare enrollment has become increasingly complex. The Social Security Administration used to enroll people into Medicare Parts A and B at age 65. But more people are waiting until after age 65 to begin receiving benefits, so automatic Medicare enrollment is less frequent.

Seniors often incur penalties because they are unaware of them or uncertain on how to avoid them. The costs can spiral quickly. For Part B, the penalty is 10 percent of the monthly premiums for each year a person went without Part B coverage. That penalty never goes away. On average, seniors facing the penalty pay 27 percent more for their premiums. And a higher proportion of older Medicare enrollees pay the Part B late-enrollment penalty compared to younger enrollees. Native Americans and Hispanics are more likely to pay the penalties.

“The federal government must help seniors navigate a complex system with clear, concise guidelines that encourage enrollment and reduce the likelihood of penalties. Too many seniors are bombarded with TV ads telling them about private plan offerings without covering the basics of how to sign up for Medicare.  The government should counter that bombardment with a fact-based approach that offers patients the best option for comprehensive, timely and affordable coverage. This is a fundamental government responsibility, and the AMA is ready to help,” Dr. Ajayi said.