What are Part A and Part B Enrollment Periods, and why is that important to me?
Be sure to see the “Medicare and You” link on the Medicare page of my web site. http://www.onsfbay.com/medicare.html
This is usually the most confusing part of Medicare because people are working past the ‘normal’ retirement age of 65 and may not even qualify for normal benefits at age 65. This is all under the purview of Social Security, but here goes. First off, remember Original Medicare consists of two pieces: Part A – covering hospital expenses; and Part B – covering doctor’s charges and the cost of other professional services. Generally, Part A becomes available to you upon reaching age 65 because you have been paying Medicare taxes, deducted through your payroll. Confirm your deduction history with Social Security. It’s an entitlement and if you qualify, there is no premium. This is known as ‘free Part A’. Part B works differently; when you file an application for Social Security benefits 3 months before you turn age 65 or 3 months after, you are automatically enrolled unless you refuse Part B coverage. Part B requires payment of a premium. For various reasons you may not file for Social Security benefits upon turning 65. So after that initial period you must enroll in it, and those enrollment periods is what this discussion is about. Be very aware that not signing up for Part B when you first become eligible can expose you to a penalty that lasts as long as you have the coverage, so contact Social Security to discuss your specific situation.
Trying to keep it simple, there are three enrollment periods for Part B: Initial Enrollment Period, General Enrollment Period, and a Special Enrollment Period. Initial Enrollment Period, we have covered: turning age 65, confirming qualification with Social Security, and beginning benefits - in the case of Part B. General Enrollment Period: If you didn’t sign up during your Initial Period for Part A (because you didn’t qualify for free Part A), or didn’t sign up for Part B (for which you must pay premiums) you must sign up during the general period between January 1 and March 31 each year. You may have to pay a higher Part B premium for your late enrollment. However possibly you can qualify for a Special Enrollment Period; Social Security will advise you of this. Special Enrollment Period: If you or your spouse are still working at the time of your Initial Enrollment Period, and therefore covered by an employer or union group health plan, you may have a chance to sign up for Part B (or purchased Part A) during a Special Election Period. This special period will be in effect during an eight month period that begins the month after the employment ends or the group coverage ends. Usually you won’t pay a late enrollment penalty if you enroll during this period.
COBRA coverage as well as retiree health plans are not considered coverage based on current employment; therefore you aren’t eligible for a Special Enrollment Period. Be careful to check with both Social Security and your California HICAP. COBRA can also be problematic for your prescription drug coverage. Always confirm that your drug plan under your COBRA coverage offers ‘creditable prescription drug coverage’. If it does not, you have another reason to enroll into Part B before leaving, or shortly after leaving, your employer or union group health plan.
On San Francisco Bay's interest is the support and protection of healthy families. Broadly that covers your direct medical coverage, pre 65 through your retirement years. Equally important is protecting the financial foundation which supports your life style.