UNITED STATES—Toni: I have just enrolled in Medicare Parts A&B and my Social Security check because I turned 65 in May. I am still working with my husband and myself covered under my employer plan.

I am being charged a much higher premium for Medicare because our 2019 tax return showed higher earnings. Can you please explain what one turning 65 with employer benefits should do because I think I made a big mistake enrolling in Medicare and still working with employer benefits?  Thanks, Tammy from Nashville, TN.

Tammy: I have good news for you because Medicare does allow those turning 65 with “true” employer benefits to delay Medicare Part B enrollment without a penalty when you want to enroll in Medicare later. Delaying Medicare does require having employer group health coverage thru yours or your spouse’s employer.

Social Security must interview you to terminate Medicare Parts A and/or B by calling your local Social Security office and discuss with the representative that you would like to terminate your Medicare because you are covered by employer’s group health coverage. If you do NOT have “true” employer group health coverage, missing your enrollment period is going to mean that you will be paying penalties. Medicare recognizes true employer and union health plans as qualified group coverage with the Medicare recipient and/or their spouse working full-time to be able to delay Medicare Parts A and B.

  • A Working Spouse: Does It Matter? If the working spouse is providing health insurance benefits from their employer group health coverage, then you want to delay enrolling in Medicare Part B. You might continue to work either part-time or as a self-employed individual, taking advantage of the coverage provided by your working spouse.
  • Self-Employed: Does It Matter? Yes, it does because if you are turning 65, not covered under an employer’s group health plan whether yours or your spouse’s employer’s benefits and waited to enroll in Medicare Part B, then you can receive a 10 percent penalty for each year that you were not enrolled, due to not enrolling in Part B at the right time. If you waited 2 years to apply for Original Medicare Parts A and B, then the penalty would be a 20 percent penalty (2 years, 65 and 66) every month for as long as that you are on Medicare or the rest of your life.

Different options to enroll in Medicare are below:

1)       Turning 65 and Receiving Your Social Security Check is the easiest way to receive your Medicare card.  Medicare will send your “Welcome to Medicare” kit 90 days before you turn 65 with your Medicare card in the kit.

2)       Turning 65 and NOT Receiving a Social Security Check because you are still working or may not be working but waiting past 65 to receive 100 percent of your Social Security benefits. Visit Social Security online at www.ssa.gov/benefits/medicare to enroll in Medicare 90 days before you turn 65.

3)       Turning 65 and “still working”- Talk to your Employer’s HR.  Ask if you need to enroll in Part B. If you do not need Part B because you are “still working” or your spouse is “still working” and you are on their group plan.  When you or your spouse are no longer covered under an employer group health coverage, at that time have your HR department fill out and sign Social Security form CMS-L564 “Request for Employment Information” and CMS-40B “Application for Medicare Part B.  Call your local Social Security office and fax the forms to justify your delay in enrollment and avoid needless penalties.

Toni King, Medicare author/advocate is giving a $5 discount to the Toni Says® readers on the new 2021 Medicare Survival Guide® Advanced book at www.tonisays.com. Have a Medicare question? Call 832-519-8664 or email info@tonisays.com.