Posted on

Senior Listening

What is a Special Enrollment Period for Medicare and when is it used?

After your Initial Enrollment Period is over, you may have a chance to sign up for Medicare during a Special Enrollment Period. For example, if you didn’t sign up for Part B (or Part A if you have to buy it) when you were first eligible because you have group health plan coverage based on current employment (your own, a spouse’s or a family member’s if you have a disability), you can sign up for Part A and/or Part B any time you’re still covered by the group health plan or during the eight-month period that begins the month after the employment ends or the coverage ends, whichever happens first. Your coverage starts the first day of the month after you sign up.

Usually, you will not have to pay a late enrollment penalty if you sign up during a Special Enrollment Period. This period does not apply if you are eligible for Medicare based on End-Stage Renal Disease or you are still in your Initial Enrollment Period.

To sign up for Part A and/ or B, contact Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.

It is important to note that COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage, retiree health plans, VA coverage and individual health insurance coverage (like coverage through the Marketplace) are not considered coverage based on current employment and do not count as employer coverage for a Special Enrollment Period. There may be reasons why you should take Part B instead of, or in addition to, COBRA coverage. You have eight months after your coverage based on current employment ends to sign up for Part B without a penalty, whether or not you choose COBRA. However, if you have COBRA and you are eligible for Medicare, COBRA may only pay a small portion of your medical costs. You generally are not eligible for a Special Enrollment Period to sign up for Medicare when that COBRA coverage ends. To avoid paying a penalty, make sure you sign up for Medicare when you are first eligible. If you have retiree coverage, it may not pay for your health services if you do not have both Part A and Part B.

There are other circumstances where you may be able to sign up for Medicare during a Special Enrollment Period. You may be eligible if you miss an enrollment period because of certain exceptional circumstances, like being impacted by a natural disaster or an emergency, incarceration, employer or health plan error, losing Medicaid coverage or other circumstances outside of your control that Medicare determines to be exceptional.

For more information, visit Medicare.gov or call 1-800-MEDICARE (1-800633-4227). TTY users can call 1-877-486-2048.

Leave a Reply

Your email address will not be published. Required fields are marked *

LATEST NEWS