UNITED STATES—Hello Toni: I am turning 65 soon and working full-time with employer benefits. I am receiving conflicting information from friends and co-workers regarding enrolling in Medicare. Some say to enroll in only Part A, while others say to enroll in both Medicare Parts A and B.

Please explain the rules about how to apply for Medicare when turning 65? Thanks, John from Rosenberg, TX.

Hi there, John: Enrolling in Medicare is very confusing! Most people think that when they turn 65, a magical switch is turned on and poof you are on Medicare! Medicare changed the rules during the Clinton administration, when Social Security extended the time for receiving 100% of your Social Security Benefits. (Social Security does the paperwork for Medicare.)

Steps to Enrolling in Medicare:

Turning 65 and Receiving Your Social Security Check:

  • You should receive your “Welcome to Medicare” Kit with your Medicare card 90 days prior to turning 65.
  • If you are not working full-time with employer benefits or covered by your spouse’s employer benefits when turning 65, please do not return your Medicare card because you do not want to pay for Medicare Part B. This can cause you to receive the “famous Part B penalty.”

Turning 65 and NOT Receiving Your Social Security Check:

  • Not receiving your Social Security check, NO automatic “Welcome to Medicare” kit when turning 65 with your Medicare card.
  • You must enroll in Medicare Parts “A, B and D” to keep from receiving a “late enrollment penalty (LEP).
  • You must enroll in Medicare online at www.ssa.gov/medicare at least 90 days prior to turning 65 for your Medicare Parts A and B to begin the 1st day of the month you turn 65.

Turning 65 and “Still Working Full-Time”:

Have Individual Health Insurance (John this is not your situation)

  • Working full-time or contract labor with individual health insurance, then you should enroll in Medicare Parts A, B and D when turning 65 to avoid a Medicare Part B and D penalty because Medicare does not recognize individual health plans as “creditable coverage.”

Have Qualified Employer benefits (John this is your situation)

  • Medicare allows you to delay your Medicare Parts “A” and/or “B” whether you or your spouse are working full-time with employer benefits not retirement benefits. “Is still working” are Medicare’s buzz words for delaying your Medicare Part B.
  • If you are 65 or older and there are 20 or more employees where you (or the working spouse) currently receive benefits, the group health insurance pays first.
  • If you are 65 or older and there are fewer than 20 employees where you (or the working spouse) receive benefits, generally Medicare pays first. Your HR department (or you) should verify with the insurance carrier as to how the current health insurance plan coordinates with Medicare to determine whether you should enroll in Medicare Parts A and/or B or should delay enrollment in Medicare.

Enroll in Medicare after 65 with Employers Benefits:

  • When you are ready to enroll after delaying your Medicare Part B due to working full-time with employer benefits have your HR department fill out and sign Social Security form CMS-L564 “Request for Employment Information” and you fill out and sign CMS-40B “Application for Enrollment in Medicare. Under #12 of CMS-40-B state which month you want your Medicare Part B to start. Take your forms to your specific Social Security office either in person (the preferred option) or fax them to enroll in Medicare Part B. Remember to write “Special Enrollment Period” (SEP) across the top of each form to avoid receiving the “famous” Medicare Part B penalty.

Sign up for the Toni Says® Medicare newsletter explaining Medicare rules at www.tonisays.com. For answers to Medicare questions email info@tonisays.com or call 832-519-8664.