I am turning 65 soon and working full-time with employer benefits. I am receiving conflicting information from friends and co-workers regarding enrolling in Medicare. Some say to enroll in only Part A, while others say to enroll in both Medicare Parts A and B.
Can you please explain the rules about how to apply for Medicare when turning 65? Thanks.
-John from Rosenberg, Texas
Hi there, John:
Enrolling in Medicare is very confusing. Most people think that when they turn 65, a magical switch is turned on, and poof you are on Medicare! Medicare changed the rules during the Clinton administration, when Social Security extended the time for receiving 100% of your Social Security benefits. (Social Security does the paperwork for Medicare.)
Below is a summary of the steps to enrolling in Medicare.
If you are turning 65 and receiving your Social Security check:
- You should receive your “Welcome to Medicare” Kit with your Medicare card 90 days prior to turning 65.
- If you are not working full-time with employer benefits and/or are covered by your spouse’s employer benefits when turning 65 and therefore do not want to pay for Medicare Part B, please do not return your Medicare card. Doing so can cause you to receive the “famous” Part B penalty.
If you are turning 65 and NOT receiving your Social Security check:
- Because you are not receiving your Social Security check, there’s no automatic “Welcome to Medicare” kit with your Medicare card when turning 65.
- You must enroll in Medicare Parts A, B and D to keep from receiving a late enrollment penalty (LEP).
- You must enroll in Medicare online at www.ssa.gov/medicare at least 90 days prior to turning 65 for your Medicare Parts A and B to begin the 1st day of the month you turn 65.
If you are turning 65 and still working full-time:
1. If you have individual health insurance (John, this is not your situation) and are working full-time or as contract labor with individual health insurance, then you should enroll in Medicare Parts A, B and D when turning 65 to avoid a Medicare Part B and D penalty. Medicare does not recognize individual health plans as “creditable coverage.”
2. If you have “qualified” employer benefits (John, this is your situation) then Medicare allows you to delay your Medicare Parts A and/or B if you and/or your spouse are working full-time with employer benefits -- not retirement benefits. “Is still working” are Medicare’s buzz words for delaying your Medicare Part B.
- If you are 65 or older and there are 20 or more employees where you (or the working spouse) currently receive benefits, the group health insurance pays first.
- If you are 65 or older and there are fewer than 20 employees where you (or the working spouse) receive benefits, generally Medicare pays first. Your human resources department (or you) should verify with the insurance carrier as to how the current health insurance plan coordinates with Medicare to determine whether you should enroll in Medicare Parts A and/or B or can delay enrollment in Medicare.
If you have qualified employer benefits and can enroll in Medicare after 65:
- When you are ready to enroll after delaying your Medicare Part B, have your HR department fill out and sign Social Security forms CMS-L564 “Request for Employment Information,” and fill out and sign CMS-40B “Application for Enrollment in Medicare Part B” yourself. Under question 12 of CMS-40-B, state which month you want your Medicare Part B to start.
- Take your forms to your specific Social Security office in person (the preferred option) or fax them to enroll in Medicare Part B. Remember to write Special Enrollment Period (SEP) across the top of each form to avoid the “famous” Medicare Part B penalty.
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Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email firstname.lastname@example.org or call 832-519-8664. Toni’s books and her newsletter are available at www.tonisays.com.