Medicare Coverage Special Enrollment Period | Medicare Made Clear

Working Past 65

Medicare Initial Enrollment Period Computer Image

A lot of people reach the age of Medicare eligibility and continue to work. Many have health insurance through their employers. What about Medicare?

Here’s what you need to know:

  • You still have a Medicare Initial Enrollment Period (IEP) when you turn 65.  You may want to enroll in Part A during this time. It’s premium free, as long as you or your spouse worked and paid Medicare taxes for at least 10 years.
  • You have to be proactive and enroll in Medicare yourself. Medicare doesn’t notify you about your IEP unless you currently get Social Security or Railroad Retirement Board benefits.
  • You may qualify for a Medicare Special Enrollment Period (SEP) that allows you to delay enrolling in Part B and Part D without incurring late enrollment penalties. You need to get confirmation of creditable coverage from your employer.

Retirement and Medicare Basics

Retiring soon? Know the Medicare basics. Your Medicare health coverage choices can vary based on your age and whether you have retiree coverage through your employer or plan sponsor. Find out what you need to know and the questions to ask to help you retire with peace of mind.

Spouses may get SEPs, too

If you’re covered by your working spouse’s employer health insurance plan, and you are 65 or older, you may qualify for a Medicare Special Enrollment Period when your spouse’s employer insurance ends. Same-sex spouses included!

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Get Your Medicare Special Enrollment Period Dates

Your SEP, if you qualify for one, begins when you retire or your employer insurance ends—whichever comes first. Find your SEP dates using this simple tool or select the tab that matches your situation.

Turning 65

Enter your date of birth

Note: This information is used only to help calculate your enrollment dates.

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Initial Enrollment Period: Turning 65 on

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Over 65 and Retiring or Losing Employer Coverage

Enter your retirement date or the date you're losing your employer coverage (whichever happens first).

Note: This information is used only to help calculate your enrollment dates.

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Special Enrollment for Parts A and B: Retiring or losing coverage in .

ENROLLMENT PERIOD

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Special Enrollment Period for Parts C and D: Retiring or losing coverage in

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Qualifying Disability
Qualifying Disability

Check the box if you have the following:

Check the box if you have the following:

Note: This information is used only to help calculate your enrollment dates.

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Enter date you began receiving disability benefits.

Note: This information is used only to help calculate your enrollment dates.

Enter date you began receiving disability benefits.

Note: This information is used only to help calculate your enrollment dates.

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Initial Enrollment Period: Began receiving disability benefits in .

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25th month of receiving disability benefits

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Medicare Coverage and ALS

You are automatically enrolled in Original Medicare Part A and Part B the month your Social Security disability benefits begin when you have ALS. It’s a good idea to apply for these benefits as soon as you are diagnosed, since there may be a waiting period before they kick in.

Even though you are enrolled in Original Medicare automatically, you may still make other Medicare coverage choices, such as adding Medicare Part D prescription drug coverage or choosing a Medicare Advantage plan.

Medicare Coverage and ESRD

You may get Medicare benefits at any age if you have ESRD and one of the following applies:

  • You are eligible for Medicare based on your work record.
  • You are already getting Social Security or Railroad Retirement Board benefits, or you are eligible for benefits.
  • Your spouse or parent meets one of the above requirements.

Medicare coverage starts the fourth month you receive dialysis treatments. For example, your Medicare coverage would start on October 1 if you start getting your dialysis treatments in July.

Medicare coverage could start the first month you receive treatments if all of these apply:

  • You attend a home dialysis training program provided by a Medicare-certified training facility.
  • Your doctor expects you to complete the training and be able to do your own dialysis treatments.
  • You maintain regular dialysis treatments throughout the usual required waiting period.

You must enroll in Original Medicare Parts A and B yourself. Once you have both Part A and Part B, you may make other Medicare coverage choices, such as adding Medicare Part D prescription drug coverage or choosing a Medicare Advantage plan.

If you are 65 or older, or disabled, and are already enrolled in Part A, you may enroll in Part B without penalty if you are approved for Medicare based on ESRD. You may also have an existing Part B late enrollment penalty removed.

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How to Use Your Medicare Special Enrollment Period

Talk with your employer health insurance plan administrator before you make any decisions. You need to understand if, and how, your plan may work with Medicare. You may be required to take full Medicare benefits (Parts A and B) at age 65 in some situations, such as if your employer has fewer than 20 employees.

During your SEP, you may:

  1. Enroll in Part B, and Part A, if you haven’t already. You have 8 months to enroll. 
This is an image that explains Medicare Special Enrollment Period, Up to 8 months Parts A and B after the last month of employment
  1. Enroll in a Medicare Advantage (Part C) or a prescription drug (Part D) plan. You have 2 months to enroll.  Learn about choosing a plan.
This is an image that explains Medicare Special Enrollment Period, 2 months to enroll in Parts C and D after the last month of employment

You are not eligible for this SEP when COBRA or retiree coverage ends. However, you may be eligible for a different SEP. Talk with your plan administrator or call the Medicare helpline for more information.

You may have additional coverage choices

If you enroll in both Medicare Part A and Part B, you may add prescription drug coverage and Medicare supplement insurance. Or, you may choose a Medicare Advantage plan.

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