Medicare Part B special enrollment period key to avoiding penalty

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 in October 2022, and both my wife and I have been under company group health benefits.

I just 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, San Antonio

Dear Vince: Because you retired in October 2022, you have missed your window to enroll in Medicare Part B as of May 31.

If you or your spouse is “still working,” those 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 eight-month window to apply for Medicare Part B and file your special enrollment period forms with Social Security.

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 February. You cannot enroll in Medicare Part B until January because you no longer qualify for a special enrollment period. You must now enroll during Medicare’s general enrollment period, according to its rules.

Here are Medicare’s enrollment periods:

Medicare initial enrollment period: An IEP runs for a seven-month span (the month of your 65th birthday, plus three months before and after that month).

Special enrollment period: Enrolling after age 65 when delaying Medicare Part B due to working full time with company benefits. This is an eight-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: Jan. 1 to March 31 is the period each year when late enrollees can sign up for Medicare Part B. Their Part B will begin on the first of the next month, and they will incur a Part B penalty.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.