Do You Have to Enroll in Medicare Upon Turning 65?

This is a question we get regularly since many of us who are over 65 are still working. Let’s look at where you fit in the Medicare universe.

If you have medical insurance coverage under a group health plan based on your or your spouse's current employment, you may not need to apply for Medicare Part B at age 65. But there are 2 qualifications for this.

·        First, your company must have 20 or more employees, and that is the total employees working for the company.

·        Second, the company health plan must be “creditable”, which means it must be at least as good as Medicare coverage. If in doubt, contact your benefits administrator.

If you satisfy those two requirements, then you will qualify for a "Special Enrollment Period" (SEP) that will let you sign up for Part B during:

• Any month you remain covered under the group health plan and you or your spouse's employment continues.
• The 8-month period that begins with the month after your group health plan coverage or the employment it is based on ends, whichever comes first.

You have 8 months to sign up for Part B without a penalty, whether or not you choose COBRA.  

There are two forms you will need for enrolling in Part B after 65. Your HR department needs to complete OMB 0938-0787 and you need to complete OMB 0938-1230. After you have those forms, call Social Security at 800-772-1213 and apply for Part B.

After you apply, it takes two to three weeks to get approved for Part B. What about Part A? You can apply for A upon turning 65 or later.

If you have questions, call Professor Medicare at 858-689-7445. Never a fee for our services.