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There are cases where an individual may enroll in Medicare outside of regular enrollment periods due to extenuating circumstances. This is known as the Medicare Special Enrollment Period (SEP). If you qualify for the Medicare Special Enrollment Period, you can enroll in Medicare outside of your Initial Enrollment Period (IEP) and the General Enrollment Period (GEP).
If you are 65 or older and are covered under a group health plan, either from your own or your spouse’s current employment, you have a Special Enrollment Period during which you can sign up for Medicare Part B. This means that you may delay your decision to enroll in Medicare Part B without having to wait for the General Enrollment Period and without having to pay the 10% premium penalty for late enrollment.
Most people get Medicare Part A without paying a premium if they’ve worked at least 10 years (40 quarters) and paid Medicare taxes. However, if you don’t have enough work history to get premium-free Medicare Part A and delay Medicare enrollment when you turn 65 because you have employer-sponsored coverage, you can also use your Special Enrollment Period to sign up for Part A. Otherwise, a late-enrollment penalty could apply for Medicare Part A if you don’t enroll when you’re first eligible and need to pay a premium.
Under such circumstances, you may:
If you do not enroll in Medicare by the end of the eight-month period, you will have to wait until the next General Enrollment Period, which begins January 1 of the next year. You also may have to pay a higher premium for Medicare Part B. If you don’t qualify for premium-free Medicare Part A, you may owe a late-enrollment penalty for Part A as well.
People who receive Social Security disability benefits and are covered under a group health plan, from either their own or a family member’s current employment, also have a Medicare Special Enrollment Period. For more information on situations that may qualify you for a Special Enrollment Period, contact Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week; TTY users can call 1-877-486-2048.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.