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What Is the Medicare Part B Special Enrollment Period for the Working Aged?

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If you qualify for Medicare, but you have health insurance through an employer’s group health plan, you may be able to delay enrollment in Medicare Part B. When your employer-based coverage ends, you may be eligible for a Special Enrollment Period (SEP) to enroll in Medicare Part B without facing a late-enrollment penalty.

If you’ve worked at least 10 years (40 quarters) while paying Medicare taxes, you typically qualify for premium-free Medicare Part A. Since most Medicare beneficiaries pay a monthly Medicare Part B premium, some people choose not to enroll in Part B or to delay enrollment. Generally, you face a lifetime late-enrollment penalty for Part B if you sign up after you’re first eligible for Medicare.

However, Medicare has a Special Enrollment Period when you can enroll in Medicare Part B without a penalty. This is how your SEP works:

If all of these apply to you…

  • you are 65 or older
  • you are still working or your spouse is still working
  • you are covered by a health plan based on current employment

…you may qualify for a SEP to enroll in Medicare Part B at any of these times:

  • while you are still covered by an employer or union group health plan
  • during the eight months following the month when the employer or union group health plan coverage ends, or when the employment ends, whichever comes first.

If you’re working and plan to keep your employer’s group health coverage, talk to your benefits administrator to help you decide when to enroll in Part B.

If your employer-based group coverage ends and you don’t enroll in Medicare Part B during the SEP, you have to wait until the General Enrollment Period to enroll and you may pay a higher Part B premium as a late enrollment penalty.

If you’re interested in enrolling in a Medicare Supplement (Medigap) plan, be aware that when your Part B coverage starts, your six-month Medigap Open Enrollment Period begins. Once this period begins, in most cases it cannot be changed or restarted.

Additionally, if you dropped Part B because you or your spouse (or family member, if you’re disabled) returned to work and had group health coverage, you can sign up for Part B again during the SEP described above and the Part B premium will not go up. Make sure your group coverage is active before you drop Part B. However, you generally will not get another Medigap Open Enrollment Period when you restart Part B.

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