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How to Apply for Medicare Part B (Medical Insurance) During Your Special Enrollment Period
SSA.gov
How to Apply for Medicare Part B
(Medical Insurance) During Your Special
Enrollment Period
At age 65, most people in the United States should enroll in
Original Medicare (Part A and Part B). However, since Part
B has a monthly premium that must be paid, some people
sign up for Part A only. They don’t enroll in Part B at age 65,
because they:
• Are still working and are covered by an employer’s
group health plan.
• Have a spouse who’s working and has medical
coverage under their spouse’s employer’s group
health plan.
Also, some individuals want to continue making
contributions to a Health Savings Account (HSA).
However, if they enroll in Medicare, Social Security, or
Railroad Retirement Board (RRB) benets, they may
incur a tax penalty from the Internal Revenue Service
(IRS). In either case, a Special Enrollment Period (SEP)
may be available when it becomes necessary for them to
start their Medicare coverage.
The SEP allows most beneciaries who meet the
conditions outlined above to enroll in Medicare without
having to wait for the General Enrollment Period (GEP).
This allows them to avoid having a gap in medical
coverage and paying a penalty for late enrollment. There
are limitations, so we strongly advise you to contact the
Centers for Medicare & Medicaid Services (CMS) for
more information. The contact information for CMS is on
the next page of this fact sheet.
NOTE: Ask your personnel ofce if you have group
health plan coverage. People with group health
coverage based on current employment may be able
to delay Part A and Part B. They won’t have to pay a
lifetime late enrollment penalty if they enroll later.
If your employer has fewer than 20 employees, Medicare
generally pays rst.
When can I enroll in my SEP?
You can use an SEP to enroll in Medicare Part B while
you’re still in a group health plan based on current
employment. Also, if your employment ends or employer-
provided medical coverage ends, you have eight months
from that month (whichever comes rst) to sign up for
Medicare Part B. This will prevent a delay in coverage
and possible penalty.
NOTE: The following don’t count as coverage based
on current employment: Consolidated Omnibus Budget
Reconciliation Act (COBRA) coverage, retiree health
coverage, Veterans Affairs (VA) coverage, or individual
health coverage (like through the Health Insurance
Marketplace).
You cannot enroll in Medicare using a SEP during
your Initial Enrollment Period (IEP). Your IEP starts
three months before the month you reach age 65 and
ends three months after the month you turn 65. If you
want to know more about enrollment periods, go online
and read Medicare (Publication No. 05-10043) at
www.ssa.gov/pubs/EN-05-10043.pdf or talk to your
personnel ofce.
When will my Part B coverage start?
You may sign up while you’re still in a group health plan
or during the rst full month when you’re no longer in the
plan. Also, you may sign up when the covered employee
stops working (whichever happens rst). If so, your
coverage will begin at either time below:
• On the rst day of the month you enroll.
• On the rst day of any of the following three months of
your choice.
If you enroll during any of the remaining seven months of
the SEP, your coverage will begin on the rst day of the
following month.
NOTE: Premium-free Part A coverage begins six
months before the date you apply for Medicare (or
Social Security or RRB benets). It can begin no earlier
than the rst month you were eligible for Medicare.
You can’t contribute to your HSA once your Medicare
coverage begins. To avoid a tax penalty, you should
stop contributing to your HSA at least six months before
you apply for Medicare.
NOTE: Some beneciaries with higher incomes will pay
a higher monthly Part B premium. For more information
about the premium amount higher income individuals
pay, visit our webpage Medicare Premiums: Rules for
Higher Income Beneciaries at www.ssa.gov/benets/
medicare/medicare-premiums.html.