Working Past Age 65?

Special Enrollment Periods for Working Past 65

Today, many people are choosing to work past 65.  By doing so, you might elect to keep your  employer benefits until you decide to dis-enroll from these benefits or retire. With either scenario, you are eligible for a Special Enrollment Period (SEP) that would provide you a period of time to enroll in Parts B and D penalty-free.

Prior to determining your SEP eligibility after your Initial Enrollment Period, you should discuss with your employer how your existing health plan coincides with Medicare enrollment. Next, determine what documentation is required to qualify you for a Special Enrollment Period.

Are You the Primary or Secondary Payer?

Employers with Under 20 Employees

According to the Centers for Medicare & Medicaid Services (CMS), if you work for an employer with under 20 employees, your health plan will be considered secondary and Medicare will become your primary. Failing to enroll into Medicare in this situation, you would, by default, become the primary payer of your claims and bills.

Employers with Over 20 Employees

According to the Centers for Medicare & Medicaid Services (CMS), if you work for an employer with over 20 employees, your employer benefits would be primary and Medicare would be secondary.

When to Enroll if Working Past 65

If you chose to continue working past 65, you have a delayed Part B scenario that would qualify you for an SEP.

If your employer has under 20 employees, you can apply for Medicare during your IEP or any time during the 8 months after the first month from when you lost employer coverage.

If you work for a larger company with over 20 employees, you can elect to enroll in Medicare Parts B and D anytime whether working or retiring.

Once you have stopped working or after your coverage with your employer ends, you have 8 months to enroll in Medicare Parts A and B.  This eight-month period begins the month that your coverage ends or you stop working, whichever happens first. 

This SEP begins the month you no longer have coverage and continues for two additional months. You may choose a plan effective date up to 3 months after the month in which the individual completed the enrollment request.

TIP:  Before deciding to delay coverage, verify your Special Enrollment Period eligibility to avoid paying any of the late penalty fees for Parts A, B or D.

How we can help if you're working Past 65

We will guide you through delaying enrollment in Medicare and maintaining creditable coverage (Medicare-approved employer health insurance coverage), so you can avoid the risk of late enrollment penalties.

Do You Qualify?

Determine if you qualify for a Special Enrollment Period (SEP) to delay Medicare enrollment penalty-free.

Creditable Coverage

Obtain Creditable Coverage Certificate for Medicare Part D.

Coordination of Benefits

Determine if Medicare will provide primary or secondary coverage and what that means to you (retiree, COBRA and Marketplace/ACA coverage).

Medicare Costs

Evaluate if remaining on your employer plan or transitioning into Medicare is the right option for you.

Applying for a Special Enrollment Period

Provide step-by-step guidance of what needs to be completed to apply for a SEP.

Determining Enrollment Period Eligibility

Not sure if you’re eligible for a Special Enrollment period?  Let us help you.  We can explain when and how you’ll need to enroll to have the coverage you need, when you need it, without late penalties.

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