Understanding Medicare’s enrollment periods

  • Wednesday, May 15, 2019 1:30am
  • Life

Q: What can you tell me about the different enrollment periods for Medicare? I’m planning to work past age 65 and understand Medicare offers Initial, Special and General periods in which I can enroll. How does this work?

A: At age 65, the Initial Enrollment Period is the first opportunity that most people are eligible to enroll in Medicare. If you’re already claiming Social Security benefits at least 4 months before age 65, you are automatically enrolled in Medicare, with coverage starting the first day of month you turn 65. If you’re not receiving Social Security benefits, it’s up to you to enroll in Medicare either online at SSA.gov/Medicare, over the phone at 800-772-1213 or through your local Social Security office.

You can enroll any time during the Initial Enrollment Period, which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65.

If, however, you plan to keep working and have health coverage from your employer, or from a spouse’s employer, you may want to delay Medicare Part B, which covers outpatient services, and Part D, which covers prescription drugs. But first check with the human resources department to see how your employer insurance works with Medicare.

Typically, if your employer has fewer than 20 employees, Medicare will be your primary insurer and you should enroll. But if you work for a company that has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you remain an active employee. If this is the case, you don’t need to enroll in Part B or Part D when you turn 65 if you’re satisfied with the coverage you are getting through your job. But in most cases, you should at least sign-up for Medicare Part A, which is free and covers hospital services.

If you delay Part B and Part D past age 65, you can sign up for Medicare during the Special Enrollment Period. Once you (or your spouse) stop working and you no longer have group health coverage, you have eight months to enroll in Part B. But if you miss that deadline, you’ll pay a late-enrollment penalty for the rest of your life. The penalty increases your premiums by 10 percent for each 12-month period that you don’t have coverage. The window for Part D is shorter. You must sign up for Part D within two months of losing drug coverage. If you go 63 days or more without drug coverage, you’ll pay a lifetime late-enrollment penalty that equals 1 percent of the monthly base premium (about $33 in 2019) times the number of months you don’t have Part D or other creditable coverage.

If you miss either of these first two enrollment periods, you’ll have to wait until the General Enrollment Period, which is January 1 through March 31 of each year, but your Part B and Part D coverage will not begin until July 1. And you’ll be subject to late-enrollment penalties.

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