When Is the Best Time to Enroll in Medicare?
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The timing of Medicare enrollment is critical. There’s really a world of difference between enrolling in Medicare when you’re retired and enrolling when you continue to work beyond age 65; between becoming eligible for Medicare because you’ve reached 65 and becoming eligible because you have disabilities; between living in the United States and living abroad; between being in a traditional marriage and being in another kind of domestic relationship; and so on.
Whichever situation you’re in, it comes with certain rules that you need to be aware of before signing up. Take a look at the table, in which are listed 12 separate situations that affect the timing of Part B enrollment alone. (Part B is the tricky one to pay attention to if you want to avoid hefty late penalties down the road.)
Find your situation to see when you should sign up. You can use this table to see at a glance whether you should sign up for Part B during your initial enrollment period (IEP) at age 65 or whether you can wait until a later date and qualify for a special enrollment period (SEP).
This table applies only to people who qualify for Medicare at age 65 or older — including non-U.S. legal residents (green card holders) who have lived in the United States for at least five years or have been married to a U.S. citizen or legal resident for at least one year. It doesn’t apply to those who qualify for Medicare at younger ages through disabilities.
Part D enrollment has different rules and conditions. Make sure you become aware of the consequences of not enrolling by the time your personal deadline has come and gone.
|Your Situation||Should You Sign Up during Your IEP at 65?||Can You Delay Part B at 65 and Sign Up during a SEP?|
|1. You have no other health insurance.||Yes.||No.|
|2. You still work and have group health insurance from a current employer.||Only if the employer has fewer than 20 employees and Medicare is primary (pays before other insurance), or if you want to drop this insurance.||Yes — any time while you still work for this employer or within eight months of retirement.|
|3. You have group health insurance from your spouse’s current employer.||Only if the employer has fewer than 20 employees and Medicare is primary, or if you want to drop this insurance.||Yes — any time while your spouse still works for this employer or within eight months of retirement.|
|4. You have individual (nonemployer) insurance that you pay for yourself.||Yes.||No.|
|5. You’re covered by COBRA insurance.||Yes.||No.|
|6. You’re covered by retiree health benefits from your or your spouse’s ex-employer.||Yes.||No.|
|7. You’re in a same-sex marriage and are covered by your spouse’s employer insurance.||Maybe. See the note that follows this table.||Maybe. See the note that follows this table.|
|8. You’re in a nonmarital relationship with someone of the opposite sex and are covered by his or her employer insurance.||Yes unless your relationship is considered a common-law marriage under the laws of your state.||No unless your relationship is considered a common-law marriage under the laws of your state.|
|9. You have veteran’s health benefits from the VA system.||Yes unless you also fall into situation 2 or 3.||No unless you also fall into situation 2 or 3.|
|10. You live outside the United States, where you can’t use Medicare services||Yes if you’re not working.||Yes if you work and have employer insurance or access to the host country’s national health care system.|
|11. You’re in prison, where you can’t use Medicare services.||Yes.||No.|
|12. You don’t qualify for premium-free Part A benefits.||Yes unless you fall into situation 2 or 3||No unless you fall into situation 2 or 3.|
At the time of writing, the Social Security Administration is still working on new regulations to take into account the 2013 Supreme Court ruling that struck down the Defense of Marriage Act. It is not yet clear whether same-sex spouses who live in states that don’t recognize same-sex marriage will be able to delay Part B and get a later special enrollment period if they are covered by their spouses’ employer insurance.