Navigating Medicare Part B enrollment after age 65

Dear Toni: My husband, Jay, retired six years ago when he turned 65. He enrolled in Medicare Part A only and decided to delay Part B since I put him on my employer’s group health plan. Recently, I read an article about failure to enroll in Medicare Part B when turning 65 and the additional cost for each year that one delays enrollment.

I plan to keep my husband on my policy until my retirement in three years when I turn 65. I spoke with a representative at the Social Security office and asked if Jay would receive a penalty for delaying enrollment in Part B. The rep said he would not but that Jay will need to provide evidence that he has been enrolled in my employer health insurance.

I am overwhelmed about what to do about Jay’s Medicare when I retire at 65. — Shirley, Dallas

Dear Shirley: The Social Security representative gave you excellent advice about your husband’s Medicare.

Basically, form CMS L564, “Request for Employment Information,” will need to be filled out and signed by your human resources department, and Jay will fill out CMS 40B form, “Application for Enrollment in Medicare Part B.” Under the remarks section of CMS 40B, state which month that Jay wants his Medicare Part B to start. Across the top of each form write “special enrollment period” to keep from receiving a Part B penalty.

Avoiding a Part B penalty when enrolling after 65, as you noted, can be overwhelming. But initial enrollment is not the only stressful issue. A reader recently visited the Toni Says office for a consultation because his wife is retiring. The husband, 72, has been enrolled in Medicare Parts A and B since he turned 65 in 2018.

The wife, who qualified for the Medicare supplement open enrollment (six-month enrollment period) because her Parts A and B began this past February, can pick whichever Medicare supplement plan she desires without having to answer any health questions.

But they are experiencing the agony of trying to enroll the husband in a Medicare supplement with health issues. He is currently on spousal company benefits and Medicare Parts A and B. However, because he has been enrolled in Medicare since 2018, he can only apply for a “guaranteed issue” Plan F Medicare supplement policy, as he has heart and cancer issues that keep him from qualifying medically.

Readers, you must have a current company benefit termination letter to prove to the Medicare supplement insurance company that you are in a guaranteed issue period to avoid having to answer underwriting questions. If you do not have a current termination letter and you have health issues, then you will not qualify medically and will have to choose an Advantage plan HMO or PPO.

Also, remember if you leave employer benefits and decide to enroll in a Medicare Advantage plan, you should first verify that your medical providers are in the network for that plan.

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.