- You do not get an SEP, and therefore cannot delay enrolling in Part B past 65 without risking late penalties, if:
(a) Your (or your spouse's) employer's health plan automatically becomes secondary to Medicare when you turn 65 — which may happen if the employer has fewer than 20 workers.
(b) You are retired (and not covered by your spouse's insurance at work) even if you have retiree health benefits.
(c) You are covered by COBRA temporary group health insurance.
(d) You are covered by the employer insurance of a domestic partner (whether opposite sex or same sex) to whom you are not married
In all these circumstances, the Part B penalty clock starts ticking at the beginning of the month after your IEP expires.
- If you have individual health insurance the penalty clock starts ticking at the beginning of the month after your IEP expires. (With individual, instead of group, insurance, you don't get an SEP if you delay joining Part B even if you continue to work after age 65)
- If you become entitled to Medicare at a younger age through disability, your deadline may vary according to the same circumstances explained above, with three exceptions:
o If you are covered by a group health plan provided by an employer for whom you or your spouse are working, you may be required to enroll in Part B if the employer has fewer than 100 employees.
o If you are covered as a “family member” under the employer plan of your domestic partner, you are entitled to delay Part B without penalty until that employment ceases—provided that the employer has 100 or more employees.
o If you miss your deadline for signing up for Part B and incur a penalty, the clock will be reset as soon as you turn 65. You'll then be eligible for Medicare based on your age instead of disability and you will no longer have to pay the penalty.
- If you live outside the United States after you turn 65, and you are not working, the penalty clock starts ticking at the end of your IEP. To avoid a late penalty, you must enroll and pay Part B premiums, even though you cannot use any Medicare services while overseas. You do not get an SEP to sign up when you return to live in the United States.
- If you are working outside the United States after turning 65, you are allowed a special enrollment period to sign up for Part B on your return if you have had American-style group health insurance from an employer; or were covered by the national public health system of the country where you live; or had coverage from an approved American volunteer program. These rules also apply to your covered spouse.
Note: If your state pays your Part B premiums under a Medicare Savings Program for people with limited incomes, the state will also pay any Part B penalties you've incurred.
Patricia Barry is a senior editor for AARP Integrated Communications and author of “Medicare For Dummies” (Wiley/AARP, October 2013).
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