“Still Working” … Medicare’s Magic Words for Enrolling in Part B Correctly!!

Published 5:43 pm Saturday, August 12, 2023

Dear Toni,

I’m losing the battle with Social Security about me and my wife enrolling in Medicare Part B since I am losing my group benefits effective July 31. I took early retirement during October 2022 and both me and my wife have been under company group health benefits. I now found out that I had to be an active employee to enroll in Medicare Part B without receiving a penalty. No one ever told me this. Please explain what Medicare rule I am not following.


Now I must pay for COBRA which costs over $1,500 a month for both of us.

Thanks, Vince from San Antonio, TX




Hello Vince:

I do not have good news for you. Because you retired in October 2022, you have missed your window to enroll in Medicare Part B as of May 31st.


You or your spouse is “still working” are magic words when it comes to enrolling past 65 and losing your or your spouse’s company benefits. The Medicare and You Handbook discusses delaying Medicare Part B until you are leaving your spouse’s or your group benefits, saying that “your 8-month Special Enrollment Period to sign up for Part B starts when you stop working, even if you choose COBRA or other coverage that’s not Medicare.”


You thought that you were protected because of your continued employer group health plan and severance retirement package, so you and your wife waited past the 8-month window to apply for Medicare Part B and file your CMS-L564 forms to be accepted by Social Security (which enrolls one in Medicare).  Chapter 7 of Toni’s new book, Maze of Medicare explains in detail Medicare’s magic words, “is still working”.


Vince, you and your wife have a big problem because your group plan is ending July 31 and now you cannot get your Medicare Part B to begin until next February 2024. You cannot enroll in Medicare Part B until January 2024 because you no longer qualify to enroll during a Special Enrollment Period. You must now enroll during Medicare’s General Enrollment Period, according to its rules.


Below are Medicare Enrollment Periods:


Medicare Initial Enrollment Period:  An IEP begins 3 months before turning 65, the month one turns 65, and 3 months after a person turns 65.


Special Enrollment Period:  Enrolling after 65 when delaying Medicare Part B due to working full time with company benefits. This is an 8-month window (a grace period) to sign up for Part B without receiving a Part B penalty. (You need the CMS-L564 form, aka Request for Employment Information, signed by HR and returned to Social Security with your Part B application).


General Enrollment Period: January 1-March 31 is the period each year when those who are late enrolling can enroll in Medicare Part B without receiving a Part B penalty. Part B will begin on the first of the next month and they will receive a Part B penalty.


Many are not aware of the Medicare Part B and Part D monthly penalty. With no Part B or Part D coverage, you will pay 100% for those benefits. Don’t wait!


Remember, with Medicare… what you don’t know WILL hurt you! Need Medicare help? Call the Toni Says Medicare hotline at (832) 519-8664 or email info@tonisays.com for assistance.

Toni’s new book “Maze of Medicare” is available to the Toni Says® readers and their friends at www.tonisays.com.