Suppose you or your spouse have been paying Medicare taxes for at least ten years while employed. In that case, Social Security automatically enrolls you into Original Medicare Part A and Part B when you turn 65. However, if you or your spouse are still employed and covered under a group health plan by your employer, you may want to delay your Medicare enrollment until you lose your current health coverage or stop working.
So what does enrolling in Medicare after 65 look like, and are there any penalties for delaying Medicare enrollment past 65? This guide takes you through the process of applying for Medicare after age 65. You can also reach out to The Medicare Family at any time if you have more questions on the topic.
When Medicare Coverage Starts
The time your Medicare coverage becomes active depends on which period you sign up. After turning 65, you have an Initial Enrollment Period (IEP) that lasts for seven months (three months before and after you turn 65, plus your birthday month).
During this time, you can fill out an application form for Medicare to enroll in part A of Original Medicare (hospital insurance) that covers inpatient care in a skilled nursing facility, hospital, hospice care, and home health care. You can also enroll in Part B Original Medicare (medical insurance) which covers outpatient care, home health care, medical equipment such as wheelchairs, doctor’s services, and preventive services like yearly shots.
Part A coverage begins up to 6 months after your initial sign-up and has no monthly premiums. Part B starts the following month after you sign up. Still, you can choose not to enroll in a Medicare plan until you’re over 65, especially if you or your spouse is part of a group health plan or health savings account program.
How to enroll for Medicare (Part A and Part B) After Age 65
Suppose you’re above the legal age limit for Medicare and have been paying Medicare taxes but didn’t enroll during your Initial Enrollment Period like many others who signed up for Medicare at age 65. In that case, you can only enroll in Original Medicare (Part A and Part B) in any of the subsequent enrollment periods explained below.
General Enrollment Period
The General Enrollment Period (GEP) is the only chance to qualify for Part A and Part B of Original Medicare if you did not do so during the IEP. Enrollment happens between January 1 and March 31, and coverage starts on July 1. If you don’t sign up during the GEP, you may be charged a late enrollment fee unless you qualify for a Special Enrollment Period.
Special Enrollment Period
There are specific enrollment periods when you can sign up for Part B and Part A Premium Medicare if your situation fits the criteria. Such a period is available only for a limited time.
So, suppose you miss your chance to sign up for Medicare during the Special Enrollment Period. In that case, your only option is to enroll in the General Enrollment Period, whereby you may pay a late enrollment fee.
Some of the particular situations that qualify for the Special Enrollment Period include:
- You’re receiving health insurance from your current job: Suppose you’re still working after 65 and receiving health insurance in the form of a group health plan or health coverage by you or your spouse’s employer. In that case, you have an eight-month period to enroll in Part A and Part B Medicare after you lose your group health plan or stop working without penalties.
- You’re serving as a volunteer in a foreign country: If you’re an international volunteer for a tax-exempt NGO for 12 months and have active health insurance, you have six months to enroll in Medicare without penalties.
- You’re part of TRICARE: If you’re enrolled in another drug coverage program that is as good as Medicare prescription, such as TRICARE, you can apply for Original Medicare in the Special Enrollment Period.
Coverage usually begins the following month after you sign up. Still, not all situations qualify for the Special Enrollment Period. These include:
- If you’re diagnosed with End-Stage Renal Disease.
- If you lose or have Marketplace coverage.
- If your health or COBRA coverage ends and you miss your eight-month opportunity to sign up for Medicare, you can only apply during the next General Enrollment Period.
Other Health Coverage Available after 65
Part D Medicare (drug coverage), covering the cost of prescription drugs and continuous shots or vaccines, is a plan you can sign up for after age 65. You can enroll in a Medicare Advantage Plan or Medicare drug plan after 65, provided you’re part of job-related health insurance or creditable drug coverage program and have signed up for Part A or Part B Original Medicare.
You must pay the Part D monthly late enrollment fee if you enroll during the General Enrollment period. However, if you enroll during the Special Enrollment Period, paying the late enrollment penalty depends on whether:
- you spend more than 63 days or two months without creditable drug coverage after your creditable drug coverage ends or becomes non-creditable, or
- if you don’t have any drug coverage, you enroll in a Medicare drug plan within three months after your Medicare coverage starts.
You will pay the total late enrollment penalty if you meet either of these criteria.
Ease the Process With Help From a Licensed Agency
Medicare is an excellent program for individuals aged 65 or older. The Medicare Family helps seniors navigate the application process. For assistance, reach out to us so you can receive guidance on enrolling in Medicare after 65 or as needed wherever you are in the process.
