Medicare Enrollment Periods For Part A & Part B: The Special Enrollment Period

As people continue to live longer, they continue to work longer. That means they may find themselves on the job at age 65. As discussed on Monday, age 65 is the age that Medicare becomes available and the time most people sign up for it. But what if you already are covered by an employer’s group health plan when you find out that Part B requires a basic premium of $134.00?  (Medicare Part  A is premium free to those who paid the Medicare tax while working and have 40 work credits with Social Security.)

Medicare is aware of this situation and offers a special enrollment period for Part B in case you want to defer it until after you have stopped working and no longer have your employer’s group health plan.     Here is where to find more information from Medicare’s own resources: Enrolling for Part A and Part B : https://www.medicare.gov/Pubs/pdf/11036-Enrolling-Medicare-Part-A-Part-B.pdf.

You can sign up for Part B during a Special Enrollment Period, but only if you meet certain requirements. If you’re covered under a group health plan based on current employment, you have a Special Enrollment Period to sign up for Part A and/or Part B at any time as long as you or your spouse (or family member if you’re disabled) is working, and you’re covered by a group health plan through the employer or union based on that work. You can also sign up during the eight-month period that begins the month after the employment ends or the group health coverage ends, whichever happens first.

You can’t enroll using a special enrollment period if your employment or the employer-provided group health plan coverage ends during your initial enrollment period

When you enroll in Medicare Part B while you’re still in the group health plan, or during the first full month when you are no longer in the plan, your coverage begins either:

  • On the first day of the month you enroll; or
  1. By your choice, on the first day of any of the following three months.

If you enroll during any of the remaining seven months of the “special enrollment period,” your Medicare Part B coverage begins on the first day of the following month.

If you don’t enroll by the end of the eight-month period, you’ll have to wait until the next general enrollment period, which begins January 1 of the next year. You may also have to pay a late enrollment penalty for as long as you have Part B coverage, as described previously.

Note: COBRA and retiree health plans aren’t considered coverage based on current employment. You’re not eligible for a Special Enrollment Period when that coverage ends.

You can sign up for premium-free Medicare Part A (Hospital Insurance)(if you’re eligible) any time after your Initial Enrollment Period starts. (Premium-free Medicare A means you were paying the Medicare tax while you were still working as well as paying the F.I.C.A. tax.  Most retired workers qualify for premium free Medicare.)  Your Part A coverage will start 6 months back from the date you apply for Medicare (or Social Security/RRB benefits), but no earlier than the first month you were eligible for Medicare

Here’s the take-away for Medicare enrollments:  Make sure you understand how Medicare will work in your personal situation, so you won’t sign up late and pay a late enrollment penalty.  Research Medicare before you turn age 65, so you’ll understand how Medicare works for you.