If you’re new to Medicare, you need to know and understand the enrollment periods. These enrollment periods are essential because you can only enroll in Medicare during these windows. Many people think they can apply for Medicare anytime during the year, and that’s not true. There are only three enrollment periods associated with your Original Medicare enrollment.
The first enrollment period is when you are first eligible for Medicare. It’s called the Initial Enrollment Period (IEP), starting three months before your 65th birthday month and ending three months after. Those with small employer insurance, retiree coverage, ACA coverage, Tricare/VA benefits, or uninsured will want to apply for Medicare within this 7-month window.
However, many seniors are working well into their full retirement age. If this is the case for you, you may have a Special Enrollment Period (SEP). Here is what you need to know about the Part B SEP and how to enroll, but if you want to learn more about Medicare’s creditable coverage, you can read about Part B on boomerbenefits.com.
How to qualify for the Part B Special Enrollment Period
It’s more common for seniors to work past retirement age. Working past 65 can help provide medical insurance and income and keep you busy. If you or your spouse are actively working for an employer with 20 or more employees when you turn 65 and that insurance covers you, you can delay Medicare past 65. Since large employer insurance is creditable for Medicare, you can delay with no penalty.
You can continue to delay Medicare until you retire. When you retire, you will qualify for a Special Enrollment Period which starts the day you lose your job or coverage, whichever happens first. It’s an 8-month window in which you can apply for Medicare Part A and Part B.
Necessary forms you can’t forget
When you apply for Medicare during a SEP, you must provide documentation. You can apply for Part A online, but Part B is a different process. First, you must complete CMS form 40B, which is the Part B application.
You will also need to give the HR department of the employer CMS form L564. They will help complete some of this document which proves you had creditable coverage while you delayed Medicare past 65.
Once you complete both forms, you can submit them to Social Security in several ways. You can upload them online, mail them to a local SSA office, fax them, or take them in person.
Since it can take Social Security several weeks to process the paperwork, submitting them at least two months before the effective date you need is recommended.
Working for a small employer
If you are self-employed or work for an employer with less than 20 employees and are covered by that insurance, you won’t qualify for a Special Enrollment Period. Therefore, if you think you can delay Medicare past 65 because you are working, you will be penalized in the future when you apply. That’s why you’ll want to enroll in Medicare during your Initial Enrollment Period. You can continue to work even when enrolled in Medicare, and your employer insurance will be secondary to Medicare. However, sometimes it may be more cost-effective to opt out of the employer insurance and explore Medicare plans.
Do your research
Those approaching Medicare age should take the time to prepare for Medicare. It’s far different from employer coverage, and understanding the rules and enrollment windows is crucial in retirement. If you miss the correct enrollment window, you can face a lifelong penalty that could have been easily avoided.