Even though Americans who age into Medicare have the choice to put off enrolling in Part B, individuals who make that selection need to proceed with caution to avoid enrollment penalties that could continue for the foreseeable future.
When is the Medicare Part B Special Enrollment Period?
The Medicare Part B SEP allows a person to delay taking Part B if you have coverage through your own or a spouse’s current job. Usually, you can take about eight months from when employment ends to enroll in Part B. Coverage that is not through a current job – such as COBRA benefits, retiree, or individual-market coverage – will not help you qualify for this SEP. However, the special enrollment period for Medicare lasts for eight months, and therefore, you may still qualify if your employment ended recently.
Do I qualify for the Medicare Part B Special Enrollment Period?
During the Medicare initial enrollment period, a person qualifies for the Part B SEP if:
- He/she is eligible for Medicare because of age or because you collect disability benefits. (People who have ESRD Medicare are excluded)
- He/she had Medicare Part B or current employment-based health coverage in the month one qualified for Medicare
- less than eight months have elapsed since you did not have either current job-based group health coverage or Medicare Part B.
- Some people may be required to use the Part B SEP if they are still working. You will want to sign up for Part B if your employer has not more than 20 employees. That is because your employer plan pays only after Medicare does. If you do not enroll in Part B, your employer plan will pay less for your care or nothing at all when it finds out you are Medicare-eligible. If your employer has over 20 employees, you do not have to take Part B when you are still working. However, a very few people do enroll to lower their out-of-pocket costs. If you have Medicare because of a disability, you will require to enroll in Part B if your employer has less than 100 employees.
- You have to take Part B once your employment or that of your spouse’s ends. Medicare becomes your primary insurer once you stop working. That will be the case even if you are still covered by the employer-based plan or COBRA. If you fail to enroll in Part B, your insurer will “claw back” the amount it paid for your care when it finds out. At this point, you would need to enroll in Part B. Unfortunately, you might no longer qualify for the SEP if you delayed enrolling for more than 8 months.
- Enrolling in Medicare when you already have COBRA will cause the COBRA coverage to end. If that happens, your spouse and any other dependents can continue coverage under the COBRA plan, even if you are no longer covered.
How do I use the Part B Medicare special enrollment period 2020?
To take advantage of the Medicare special enrollment period 2020, you should call the Social Security Administration and request two forms. That includes the Medicare Part B enrollment request form (CMS 40B) and the request for employment information form (CMS L564). The Medicare enrollment application should be completed, and the request for employment information form given to the employer to fill out. It would be best if you want to request additional copies of form L564 from Social Security if you have been covered through more than one job-based plan since you qualified for Medicare.
If an employer is unable to fill out the form, Social Security may accept the following items as evidence that you had job-based coverage:
- W-2s or pay stubs showing pre-tax medical insurance premiums withheld
- Income tax forms showing you paid health insurance premiums
- explanations of benefits
- statements or receipts showing you paid health insurance premiums
- health insurance cards with a policy effective date;
What if an Employer Gives the Money to Buy a Personal Health Plan?
It is prudent to note the following about individual coverage before enrolling during the Medicare enrollment period 2020. You would qualify for a SEP if you delayed Part B because you had employer-sponsored coverage through a group health plan (GHP). Notably, this is a specific type of insurance plan sponsored or run by your employer. It comprises coverage your employer offers you through an insurer and plans purchased from the Small Business Health Options Program (SHOP) marketplace. For more information about special enrollment period for Medicare , contact health insurance today.