'Still working': Medicare’s magic words for enrolling in Part B correctly

Editor's Note: The question in this column originally ran in May 2022. Toni's answer has been updated.

Dear Toni: I'm losing the battle with Social Security about me and my wife enrolling in Medicare Part B since I am losing my group benefits effective July 31. I took early retirement during October 2022 and both my wife and I have been under company group health benefits. I now found out that I had to be an active employee to enroll in Medicare Part B without receiving a penalty. No one ever told me this. Please explain what Medicare rule I am not following. Now I must pay for COBRA which costs us more than $1,500 a month. — Vince from San Antonio

Hello Vince:

I do not have good news for you. Because you retired in October 2022, you have missed your window to enroll in Medicare Part B as of May 31.

You or your spouse is "still working" are magic words when it comes to enrolling past 65 and losing your or your spouse's company benefits. The Medicare and You Handbook discusses delaying Medicare Part B until you are leaving your or your spouse's group benefits, saying that "your 8-month Special Enrollment Period to sign up for Part B starts when you stop working, even if you choose COBRA or other coverage that's not Medicare."

You thought that you were protected because of your continued employer group health plan and severance retirement package. You and your wife have waited past the 8-month window to apply for Medicare Part B and file your Special Enrollment Period CMS-L564 forms to be accepted by Social Security (which enrolls one in Medicare). (Chapter 7 of Toni's new Maze of Medicare book explains in detail Medicare's magic words, "is still working.")

Vince, you and your wife have a big problem because your group plan is ending July 31 and you now cannot get your Medicare Part B to begin until next February 2024. You cannot enroll in Medicare Part B until January 2024 because you no longer qualify to enroll during a Special Enrollment Period. You must now enroll during Medicare's General Enrollment Period, according to its rules.

Below are Medicare Enrollment Periods:

Medicare Initial Enrollment Period: An IEP begins 3 months before turning 65, the month one turns 65, and 3 months after one turns 65.

Special Enrollment Period: Enrolling after 65 when delaying Medicare Part B due to working full time with company benefits. This is an 8-month window (a grace period) to sign up for Part B without receiving a Part B penalty. (You need the CMS-L564 form (Request for Employment Information) signed by your human resources department and returned to Social Security.)

General Enrollment Period: January 1-March 31 is the period each year when those who are late enrolling can enroll in Medicare Part B. Their Part B will begin on the first of the next month, and they will receive a Part B penalty.

Many are not aware of the Medicare Part B and Part D monthly penalty. With no Part B or Part D coverage, you will pay 100% for those benefits. Don't wait!

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 [email protected] or call 832-519-8664. You can now visit www.seniorresource.com/medicare-moments to listen to her Medicare Moments podcasts and get other information for boomers/seniors. Toni's new book, Maze of Medicare, includes quotes and scripture to relieve the stress and anxiety associated with transitioning to Medicare. Look for it starting July 4 at www.tonisays.com.