Medicare Frequently Asked Questions

 

 

  1. I’m turning 65 soon, still working, and I have insurance through my work.  Do I need to sign up for Medicare? 

If you or your spouse (or family member if you have a disability) is still working and you have health insurance through that employer or union, contact your employer or benefits administrator to find out how your coverage works with Medicare.  It may be to your advantage to delay Part B enrollment.  Once your Part B coverage begins, so does your Medigap Open Enrollment Period (see question 6 below for more information about Medigaps).  

NOTE:  Coverage based on current employment does not include COBRA, retiree coverage, VA coverage or individual health insurance purchased on the Health Insurance Marketplace. 

Contact the SHIP office if you have any further questions about signing up for Medicare while you have employment-based insurance.  However, contact your employer to discuss how your current coverage is affected if you do sign up for Part B while still working. 

  1.  How do I enroll in Medicare Part B when I am about to retire or lose my employer-based health insurance? 

After your Initial Enrollment Period to enroll in Medicare Part B is over, you may have a chance to sign up for Part B during a Special Enrollment Period (SEP) if you or your spouse (or a family member, if you have a disability) is currently employed and you have group health plan coverage from that employment.  You can sign up any time while you’re still covered by the employer’s group health plan or during the 8-month period that begins the month after the employment ends or the coverage ends, whichever comes first. 

Usually you won’t pay a late enrollment penalty if you sign up during a SEP. This SEP doesn’t apply to people eligible for Medicare based on End-Stage Renal Disease or if you’re still in your Initial Enrollment Period. 

The Social Security Administration requires two forms to be completed and processed to facilitate the Special Enrollment.  See https://www.medicare.gov/forms-help-resources/medicare-forms, the second bullet under the middle section titled “Enrollment Forms,” to download the forms CMS-L564 and CMS-40B.  Follow the instructions on the forms, keep a copy of the completed forms for yourself and mail the originals to the local Social Security office.  (Note that the form CMS-L564 should be completed in part by your employer and returned to you.)  In light of the fact that the local Columbia office is currently closed, call the Social Security Administration at 1-800-772-1213 for the address to mail the forms. 

NOTE:  During COVID-19, CMS added an online enrollment option for Medicare beneficiaries who already have Medicare Part A and are eligible to enroll in Medicare Part B through this Special Enrollment Period.  Use this option to submit your enrollment request online. 

Once Social Security receives and processes your Medicare enrollment, you will receive a new Medicare card.  Feel free to contact SHIP if you want to discuss how to get your Medicare coverage (Original Medicare with a Part D drug plan and