Initial Enrollment with Social Security
Coordinating your Medicare with Social Security.
How to coordinate your Medicare enrollment with Social Security.
Coordinating your Medicare with Social Security is the first and most important step to getting your Medicare coverage started properly. Throughout this page, I will help you determine whether you’ll be using your Initial Enrollment Period (IEP) or Special Enrollment Period (SEP) to coordinate your Medicare with Social Security. As I review how to start your Medicare properly, I will incorporate the the steps of completing your Medicare insurance enrollment successfully as well. Let’s get started! What do we need to do to start Medicare and confirm your Medicare start date?
You’d be surprised how often the process of coordinating your Medicare with Social Security is overlooked by insurance companies and online Medicare agents. I believe this first step is the most important step that leads to confidently navigating Medicare, it’s timelines, and your Medicare insurance plan enrollment options.
Often times, I hear agents and brokers telling clients, “I’ll help you with Medicare insurance once you enroll with Social Security.” Hmm, you specialize in Medicare insurance plans, but you’re unable to advise the client on the process of enrolling in the Medicare system you sell insurance products for? I think you catch my drift. Fortunately, I built MedicareSupplementMentor.com to guide you through all Medicare enrollment scenarios.
Without properly setting up your Medicare (Part A & B) with Social Security using the Initial Enrollment Period (IEP) or Special Enrollment Period (SEP), the additional steps of insuring yourself with Medicare insurance products are irrelevant. First things first. Get your Medicare started properly!
Medicare Intial Enrollment Period (IEP)
3 months
before
65th Birthday month
3 months
after
So, when does your Medicare become effective after coordinating it with Social Security? Well, it depends on when you chose to enroll inside your Medicare Initial Enrollment Period (IEP). Below is a chart outlining when your Part B of Medicare would begin depending on the timing of your enrollment within the Initial Enrollment Period.
As a reminder, if you’re already receiving your Social Security Retirement Benefit, you’ll be automatically enrolled 3 months before your 65th birthday month, as Social Security will automatically enroll you using your IEP. Therefore, your start date will always be the 1st of the month you turn 65. If your birthday is the 1st of the month, you may start Medicare coverage the 1st of the month prior to your birthday month.
Maybe you’re not planning on starting Medicare within the 7-month window surrounding your 65th birthday? Did you work through your 65th birthday with creditable coverage through an employer? In the case you’re over 65 and leaving an employer group plan to start Part B using a Special Election Period or SEP, you will have a different set of rules for starting your Part B of Medicare. Typically, with an SEP, you’ll be able to select that specific month you’d like your Part B to begin within a 8 month period of current employer group creditable coverage.
For example, you may indicate your requested start date under the “remarks” section of Form 40B when it is submitted along with Form L654 using your Part B SEP– choose your effective date. Also, I recommend contacting Social Security to double check they established the Medicare effective date you specified on the form. Most clients start it the 1st of the month after they intend to leave the group employer plan– You don’t want a lapse in coverage, right?!
Please see the cover page of CMS forms 40B and L564 for more specific instructions, or contact my office to review and confirm your SEP timeline if this sounds like you. Read, review, and/or download 40B and L564 under Forms and Documents under the Resources drop down menu in the menu bar above.
First things first. Coordinate your Medicare with Social Security.
Review the Medicare Enrollment Scenarios in the list below to find the scenario that suits your Medicare coordination with Social Security best. Although I do not work for, or with Social Security, all my clients go through this enrollment process. I think you’ll find my explanation to be a little long winded, but the details make a difference.
If you have questions as you plan for your Medicare start date, please give my office a call so we can help. Whether it be to confirm the process, ask about online enrollment, or review SEP forms, let us know how we can help you.
Please use this information along with with SSA.gov resources to successfully complete Enrollment #1 –coordinating your Medicare with Social Security. Once this step is complete, we can move on to reviewing the Medicare plan paths Medicare insurance plans that will suit your coverage preferences.
Lastly, we can help you with Enrollment #2— enroll you in the Medicare insurance plan that alines with your coverage preferences and preferred coverage path with any plan or carrier you choose.
Medicare Enrollment - use IEP.
Are you in your Initial Enrollment Period surrounding your 65th birthday? If so, and not covered under a group employer plan, coordinate Medicare 3 months before, the month of your birthday, and if needed, three months after your birthday month. Enroll on time to avoid the Part B penalty.
Are you receiving your Social Security benefit and enrolling in Medicare at age 65?
You will be automatically enrolled in Medicare (Part A and B). Your card will be mailed to you and will indicate your Medicare coverage start dates– 1st day of your 65th birthday month (ie. Birthday, March 21st– Medicare starts March 1, 2024). The card will typically be sent 3 months prior to your 65th birthday month as Social Security will enroll you via your Initial Enrollment Period or IEP. Assuming you’ve paid into Social Security for 40 quarters (or you qualify through your spouse), Part A is premium-free to you (you were taxed!)
Medicare Part B has a separate premium. The standard premium for 2024 is $174.70 (subject to change annually). The Part B premium will be automatically deducted from your Social Security benefit since you’ve already elected to start your Social Security retirement benefit prior to your Medicare start date.
If you happen to set up your Medicare at the same time you elected to start your Social Security benefit (simultaneously at 65), the Part B premium may be deducted as an automatic monthly draft (if set up in time for Social Security billing), or it may be billed to you as a quarterly statement until the automatic monthly withdrawal is set up on your account.
Review your Social Security benefits statement to confirm the Part B premium draft ($174.70 or more if subject to IRMAA). Call your local Social Security office to confirm payment information and/or the billing for your Part B premium payment. Once you’ve successfully completed your Medicare enrollment, you can now confidently transition your focus on reviewing your Medicare insurance plan(s) options.
Mentor One Insight - Medicare Enrollment IEP
To illustrate Medicare Enrollment within an IEP(SS benefit active), I’ve detailed the steps a hypothetical client would experience throughout the process.
Roberta has been retired for a couple years and has been covered with an individual health plan until she is Medicare eligible. She is planning to transition to Medicare the 1st of her 65th birthday month (when she is first eligible). She has previously elected to start her Social Security benefit early at 62. Her birthday is February, 18 and wants to be sure her Medicare starts on the 1st of February 2024 (first possible day for her Medicare to begin). Let’s assume it’s the first week or two of November, 2023 (3 months before her 65th birthday month).
Roberta will be automatically enrolled via her IEP into Medicare since she is currently taking her Social Security benefit. She will get her Medicare card approximately 3 months prior to February. Since her Social Security benefit is already active, her Part B premium will be automatically deducted from her check each month starting in February of 2024. Her Part B premium will be the standard $174.70 and her Part A is premium-free since she worked well over the 10 years to qualify.
Her Part A and Part B effective dates on her Medicare card will both be 02/01/2024. She does not need to worry about the Part B Initial Enrollment Period (3 months before, the month of 65th bday, and 3 months after) for Medicare coordination with Social Security. Remember, Social Security automatically coordinated her Medicare using Roberta’s IEP and mailed her card directly to her. Roberta then can move on to next step of reviewing Medicare insurance product(s) here with John at MedicareSupplementMentor.com.
Roberta reviewed the “parts” and “plans” under Medicare 101 and continued making her way through the 5 Step Medicare Enrollment Guide to establish the Medicare plan path and insurance product that will give her the coverage that suits her healthcare needs. Roberta filled out the Request Help Form on the website in late November/early December to schedule a time with John. She now has an appointment scheduled to discuss plans and enroll into Medicare insurance products– everything is now in place for her 02/01/2024 start date.
Are you delaying your Social Security benefit and enrolling in Medicare at age 65?
You will need to proactively enroll into Medicare (Part A & B) 1-3 months before your birthday month for coverage to start the 1st of the month you turn 65. The Part B Initial Enrollment Period (IEP) starts 3 months before your 65th birthday, and last the month of your birthday, plus 3 additional months. Clients should apply in the first 1-3 month window prior to their birthday to insures the Medicare start date is the 1st of their birthday month.
If you’re working with a more limited timeline or you forgot to enroll, you’re able to enroll up to the day prior to your 65th birthday month (ie. March, 31st– for an April 1 start date when 65th birthday is in April). If you apply the month of or just weeks prior to your 65th birthday month, you may not have your card in hand, but you will be covered– effective as of the 1st of your 65th birthday month.
You can enroll online or in person with the Social Security office (pending appointment availability). We are available to help you through the enrollment process if you have questions. Always print a receipt of your enrollment date, write down and/or print the confirmation number from the Social Security website if enrolling online.
Since you are delaying your Social Security benefit in this scenario, there is no monthly Social Security benefit for the Part B premium to be drafted from, right? With no Social Security benefit for you to withdraw your Part B premium of $174.70, you will be receiving a direct bill in the mail. This bill will likely be quarterly, which you’ll need to continue paying to keep you Medicare active until you elect to start taking your Social Security benefit. The Part B premium will be automatically withdrawn monthly once your Social Security retirement benefit becomes active.
Referring back to the quarterly Part B bill, you will have the option to pay monthly through a checking account auto draft, or monthly credit card for the quarterly statements. You’ll need to wait until you receive the quarterly bill to set up these alternative payment options. The standard Part B premium for 2024 is $174.70 (more if subject to IRMAA). And as with all Medicare beneficiaries that worked for 10 years or 40 quarters and paid into Social Security, Part A is again, premium-free to you.
When you elect to start your Social Security retirement benefit at a later time, since you are delaying it at this time, the Part B premium will then be automatically withdrawn each month (your monthly Social Security benefit amount minus the Part B premium = monthly Social Security draft into your account). Once Medicare start dates are established, you can now begin to explore your Medicare insurance plan(s) options.
Mentor One Insight - Medicare Enrollment IEP
To illustrate Medicare Enrollment within an IEP (SS benefit delayed), I’ve detailed the steps a hypothetical client would experience throughout the process.
Mark is currently retired and works part time as a consultant, but is covered under a Covered California individual plan up until the last day of the month prior to turning 65. He received notice that his individual plan is ending on the last day of the month prior to his 65th birthday. Mark turns 65 on April 7th of 2024, so he wants his Medicare to start on the 1st of his 65th birthday month- 04/01/2024. Mark has savings and other forms of income through investments as well as his spouse’s income which is allowing him to delay his Social Security benefit to a later date. He has not decided exactly when he’ll take his benefit (he’s planning on a date between 66 and 70). For now, he is focused on only starting Medicare. Let’s assume it is early January, 2024 and his Covered California coverage ends 03/31/2024.
Mark will need to proactively coordinate Medicare it to start 04/01/2024. His Initial Enrollment Period for Part B (IEP) begins on January 1 of 2024 (3 months prior to his 65th birthday month). He can call Social Security to schedule an in-person appointment or can go online to SSA.gov to proactively enroll in Medicare prior to his desired April 1 start date. Mark and his wife show less income on their IRMAA than $182,000 so he will be paying the standard $174.70 per month for his Part B premium. He also fulfills the requirement for Part A after working for 40+ years. Therefore, Mark’s Part A is premium free.
Since he has chosen to delay his Social Security benefit at this time, there is not a monthly Social Security benefit to withdraw the $174.70 Part B premium. He will be mailed a Part B bill for $524.10 (quarterly). He can elect to pay this through his credit card or checking account monthly as soon as he receives the quarterly statement and coordinates the payment option he prefers. Mark will likely receive this quarterly bill along with his Medicare card 2-4 weeks after coordinating his Medicare with Social Security for his 04/01/2024 start date. He can then set up the monthly option as soon as he receives the Part B billing statement.
Now that Mark has completed the first part of enrollment into Medicare (Part A & B) effective 04/01/2024, he can now move to the second stage of enrollment and start reviewing Medicare 101 to begin researching the “parts” and “plans” of Medicare and Medicare insurance plan(s) options. Mark has a good idea of which “Medicare plan path” he prefers for his Medicare coverage. Mark scheduled an appointment in late January/early February to review his plan with John and begin the process of completing applications for the insurance product(s) to start along with his Medicare on 04/01/2024.
Are you working up to 65, delaying your Social Security, and enroll in Medicare at 65?
This scenario is similar to the one above, but in this situation, you are currently working and covered under your employer group plan until the last day of the month you leave your group plan and retire (this could be your spouse’s employer plan as well). You are planning to retire the month prior to your 65th birthday and looking to time your Medicare start date the day after your employer health plan benefits end (last day of the month).
Maybe you chose to work up to this date because you know the cost of insurance plans in your early 60’s are extremely expensive as an individual, and you are timing your retirement to coincide with Medicare on the 1st of your 65th birthday month– IEP Medicare start date.
In this scenario, you are delaying your Social Security benefit. Therefore, you will need to proactively coordinate Medicare (Part A & B) for coverage to start the 1st of the month you turn 65. It is best to do 3 months before your 65th birthday month (The Part B Initial Enrollment Period starts 3 months before your 65th birthday). Most clients apply in the 1-3 month window prior to their birthday (plan ahead if possible).
You can enroll online or in person with the Social Security office (pending appointment availability). We are available to help you through the enrollment process if you have questions during this stage of the process. Once enrolled online or in-person, always print a receipt of your enrollment date, write down and/or print the confirmation number from the Social Security.
Since you are delaying your Social Security benefit, there is no monthly Social Security benefit check for the Part B premium to be withdrawn from, right? For this reason, you’ll be receiving a quarterly Part B bill. You will need to continue paying this bill to keep you Medicare Part B active until you elect to start your Social Security retirement benefit– it will then be automatically withdrawn monthly. You will have the option to pay through a monthly checking account auto draft or monthly credit card. You’ll need to wait until you receive the quarterly bill to set up these other payment options. The standard Part B premium for 2024 is $174.70 (more if subject to IRMAA surcharges). Part A is again, premium-free if you have fulfilled the minimum requirement of 10 years (40 quarters).
Once you elect to start your Social Security benefit at a later time (ie. 66-70), the Part B premium will then be withdrawn automatically each month (your monthly Social Security benefit amount minus the Part B premium = monthly Social Security benefit draft into your checking account).
I chose to show this example because many times the SEP forms for leaving an employer group plan after the age of 65 can be mistakenly used in conjunction with IEP or in place of IEP (Initial Enrollment Period) 3 months prior to turning 65. Only use the SEP forms if outside your IEP or 7 month window.
IEP will take precedent over the SEP forms in this situation. To be clear, you do not want to use the SEP (leaving an employer group plan) enrollment unless you are outside the IEP period of 7 months surrounding your 65th birthday.
With that being said, for this example, he/she is enrolling prior to turning 65, yet still leaving an employer group plan. So, use the standard IEP enrollment period and proactively enroll directly with Social Security in-person or online for your Medicare (Part A & B) to begin on the 1st of your 65th birthday month.
See the SEP scenario in the next example if you are curious how this window works for someone enrolling in Medicare AFTER turning 65 and leaving an employer group plan outside their 7 month IEP window.
Again, the client established their Medicare start dates. They can now explore their Medicare insurance plan(s) options with John and set their preferred coverage plan to start on the 1st of the month they turn 65.
Mentor One Insight - Medicare Enrollment IEP
To illustrate Medicare Enrollment within an IEP leaving a group employer plan (SS benefit delayed), I’ve detailed the steps a hypothetical client would experience throughout the process.
Diane is approaching her 65th birthday – August 19th, 2024. Diane has been anticipating her retirement date since last year at 64, but after viewing the cost of medical insurance through the employer COBRA option or going on her own with an individual plan costing her approximately $1000 a month, this wasn’t an option for her. Therefore, she decided to work another year with her current employer and plans to retire in July- the month before she turns 65. Since she is currently covered under her employer group plan, she knows that if she retires the month prior to turning 65 (on the 10th of July and her 65th bday is August 19th), her Medicare coverage starts 08/01/2024. If she leaves the employer plan on the 10th of July, she will have coverage through the end of the month through the employer plan. She will have no lapse in coverage as the group plan ends 07/31/2024 and her Medicare is starting 08/01/2024.
Diane is delaying her Social Security retirement benefit and plans to take it at a later date (ie.66-70). She is focused on starting Medicare at this time and can elect to start her Social Security retirement benefit at any point she sees fit in the future. In the future, electing to start her Social Security retirement benefit will not have an effect on her Medicare coverage she is establishing at this time. It will only effect how her Medicare Part B premium is paid to Social Security (quarterly if delaying/monthly withdraw if taking the benefit).
Three months before Diane’s 65th birthday month in August, Diane should proactively enroll herself into Medicare using her IEP (Initial Enrollment Period). Again, she is proactively enrolling in Medicare in-person or online because she has chosen to delay her Social Security retirement benefit at this time. Once she has met with Social Security or confirmed her Medicare effective date/start date by enrolling in Medicare online, she is set to start her Medicare coverage – effective 08/01/2024.
Now that Diane completed the first enrollment of coordinating her Medicare properly, she can confidently continue reviewing the second stage of the enrollment process– reviewing Medicare “parts” and “plans” and the insurance plan(s) with John to find the coverage that suits her needs.
After reviewing Medicare 101 and the following steps of the process (5 Step Enrollment Guide), Diane can now confidently contact John in May, June, or July to confirm her understanding of Medicare insurance products as well as ask for quotes, pricing, and enrollment paperwork to start the enrollment process for the insurance product(s). Diane’s Medicare and Medicare insurance product(s) will all start 08/01/2024. Diane timed her retirement perfectly from leaving an employer group plan and transitioning to Medicare with no lapse in coverage.
Medicare Enrollment - use SEP.
Are you outside IEP because you worked past 65 and were covered under a group employer plan?
Use CMS Forms 40B & L564 to coordinate your Medicare and start coverage with guaranteed-issue into a Medicare Supplement Plan.
Are you working past 65, delaying your Social Security benefit, and enrolling in Medicare at a later date?
This can be the most complicated election for timing your Medicare start dates, yet it is very common. I’ll walk you through each step to thoroughly cover exactly what you need to do to get Medicare started on time, without penalties, and without any hassles. I’ll assume a few things as we go through this scenario step-by-step. Apply the basic concepts of this scenario even if your situation is slightly different based on when you choose to retire and transition to Medicare over the age of 65.
This Medicare enrollment scenario assumes you are working past the age of 65, delaying your Social Security benefit, and covered through your employer sponsored plan with more than 20 employees, or you are older than 65 and covered through your spouse’s employer sponsored plan with more that 20 employees.
Note: Im very specific with the employer group plan being more than 20 employees because if you or your spouse’s employer plan is more than 20 employees, then the employer group plan is primary to Medicare the month you turn 65 and after the age of 65 while you are working. This means that even though you are over the age of 65, you are able to skip enrollment into Part B (and technically Part A) of Medicare since it is not primary coverage (employer plan remains primary and Medicare Part B can be delayed). Therefore, enrollment into Part B can be delayed in this scenario without penalty until transitioning to full Medicare A & B the 1st of the month following retirement/leaving the employer group plan.
Part A may have been activated at 65 if you enrolled online for “Part A Only” and Part B delayed. Technically whether you enrolled in “Part A Only” or not with more than 20 employees in your group plan, “Part A Only” is just “sitting on the sidelines“ until you elect to start Part B at a later time (they then both become primary once activated via your SEP).
If your employer group plans is less than 20 employees, Medicare will be primary the month you turn 65 and the employer group plan would then act as the supplemental coverage to Medicare. If under 20 employees, you do not want to delay Part B of Medicare (confirm with your HR department). You’ll need to proactively enroll in Part B three months before turning 65 using the normal IEP even though you are still working.
I recommend you try to negotiate with your employer to pay your Part B premium as well as the employer group plan coverage acting as your supplemental in this scenario. Many times the company may offer to pay for the Part B premium, the Medicare Supplement Plan and your Part D plan while working. It is much cheaper for the employer if you to go off their group plan, so many times, they are happy to reimburse the Medicare Part B premium and Medicare insurance products for you each month. Again, this is for someone working past 65 with an employer group plan with less that 20 employees.
If you have more questions, call my office so I can go through this with you. It’s tricky, but I’m very familiar with timing these scenarios for my clients. I also recommend speaking with your benefits or HR department to confirm your employer group plan status if you plan on working past 65 and delaying Medicare Part B.
Back to the original scenario…. you are over 65, working, delaying Social Security retirement benefits, and wishing to enroll at some future date for Medicare to begin the day you leave your or your spouse’s employer group plan that is larger than 20 employees. Let’s assume, you’re 68 years old and wishing to retire in the month of September for a seamless transition to Medicare for October, 1 2024. In this scenario, your birthday is irrelevant when it comes to enrolling in Medicare with Social Security. Since you are outside the Initial Enrollment Period (IEP) (the 7 months surrounding your 65th birthday), you’ll need a different election tool to activate your Medicare properly. You’ll be using whats called, a Special Election Period or SEP.
Since you have been covered on an employer group plan prior to the month leading to your 65th birthday, you’ve had what is called creditable coverage. This creditable coverage is going to allow you to enroll into Medicare on any retirement date in the future if you remain covered under that employer group plan while employed with the company (or within a 8 month window of current coverage). For this example, we are using 10/01/2024 as the preferred Medicare start date for someone retiring in the month of September so I can be specific with dates for this illustration.
In this specific scenario you would need to print forms on SSA.gov or print from the Resources Tab under Forms and Documents on this site. These forms are SSA forms L564 and 40B.
40B is a form that you’ll use to “say” that you want to elect to start your Medicare Part B on “X” date. In this example, we are targeting 10/01/2024 for the start date. Print and fill out form 40B indicating your intended Part B start date of 10/01/2024. Under the remarks section on 40B, clearly state your intent for your Part B effective date. In this example, it would be again be, 10/01/2024.
Now, to SSA form L564. This form is what activates the use of form 40B. L564 is a form that your employer benefits administrator will fill out showing you’ve had creditable coverage under their group plan from date “X” to date “Y” –– signed by the benefits administrator/owner/operator of your company. You can get this form signed up to 8 months prior to your intended Medicare start date- 10/01/2024. In my opinion, coordinating L564 and 40B 3-4 months prior to your start date is sufficient.
To continue the example, let’s say you filled out the 40B in June/July and had your employer sign off on your creditable coverage on the L564 and returned the form to you. You can then submit both forms to the Social Security office in person or fax for your 10/01/2024 start date. If you’re working with me on this, I’ll be happy to guide you and fax the documents to the local Social Security office with your permission to get a hard copy receipt/time stamp of your SEP enrollment for 10/01/2024.
Let’s assume for ease of the this example that you are still delaying your Social Security benefit. You’re Medicare is set for 10/01/2024. You’ll receive a quarterly Part B billing statement for the Part B premium. Remember, Part A is “premium free” since you paid into the system for more than 10 years. If Part A was activated as “Part A Only” at 65 online/in-person it is in essence “sitting on the sidelines”. Once L564 and 40B are processed by Social Security, both Part A and Part B will be activated to be primary on 10/01/2024. Remember, the group employer ends the last day of September– No penalties or lapse in coverage!
Medicare is now primary and you can work with John to get quotes, pricing, and enroll yourself in the Medicare insurance plan(s) of your choice. You will have exactly the same guaranteed-issue rights as someone who went through the process when turning 65 (no health questions asked). You are not subject to late enrollment penalties for Part B or Part D because of the creditable coverage you had through the employer group plan or your spouse’s employer plan. L564 took care of the proof for the Part B penalty, but you may need to show proof of “creditable coverage” to the first enrollment into a Part D plan you enroll into whether it be a standalone Part D or Part D included in a Medicare Advantage plan. After this initial Part D enrollment, you should not need to resubmit proof of creditable coverage.
If you enroll in Medicare insurance products with my office, we will help you get this organized and submit it with your application before they even ask- avoiding any confusion as to whether you had creditable coverage or not. Best to give them the proof ahead of time than deal with a request for it at a later time.
Once you elect to start your Social Security retirement benefit at a later time (ie. 68-70 in this example), the Part B premium will then be withdrawn automatically each month (your monthly Social Security benefit amount minus the Part B premium = monthly Social Security benefit draft into your account). The standard Part B premium for 2024 is again, $174.70 (more if subject to IRMAA).
This is one example- please call if you want me to review your specific enrollment scenario so we can pin point the exact months you needs to complete each step to get everything coordinated correctly without penalties.
Mentor One Insight - Medicare Enrollment SEP
Mike is 68 (outside his IEP at 65), he is still working and delaying his Social Security retirement benefit. He is covered through a large employer plan (over 20 employees) so he can delay his Medicare Part B and use his group plan as his primary coverage while he worked past 65. He has creditable coverage through his employer plan for Part B and Part D. He can retire any month he wants and can elect to have Medicare begin without penalty on the 1st of the month he chooses. He wants to start July 1 – 07/01/2024. He is retiring June 5th – 06/05/2024, and therefore, has employer coverage through 06/30/2024 with his employer group plan (check with your benefits administrator to be sure you’re covered through the end of the month- take advantage of this if you can).
In March/April (3-4 months prior to his desired start date of July 1 – 07/01/2024), Mike printed off the forms 40B and L564 and reviewed the timing of his Medicare with John over the phone to pin point his exact dates. Since he settled on July 1 for his Medicare start date based on leaving his employer at 68 years old on June 5th. He filled out form 40B that indicated a 07/01/2024 Medicare Part B start date (Part A will become active on 07/01/2024 as well). Mike now contacts his employer benefits division to get a representative to sign off on his creditable coverage with form L564 to allow him to activate his form 40B. He submits both forms to Social Security in the month of March or early April (depending on when his employer gets the L564 back to him). Mike gets confirmation of Part B effective 07/01/2024. Part A may have an earlier date and it will always show the earlier date if elected “Part A Only”, however, Part A will become effective 07/01/2024 because the current primary insurer (employer) drops coverage on 06/30/2024. Both Medicare Part A and Part B are coordinated and effective to start covering you 07/01/2024.
He is now set for his Medicare start date of 07/01/2024 without penalty for his Medicare coverage at 68 years old. Mike meets with John to review Medicare insurance plans, pricing, and enrolls in the plan of his choice prior to July 1st. He wants all of his coverage to start on July 1. Additional creditable coverage proof is sent to the Part D plan of his choice– the Part D penalty is now not applicable to him. He is now fully covered without a lapse in his coverage. His group plan ends June 30th and his Medicare as well as his Medicare insurance product(s) all start July 1 without a lapse in coverage.
Coordinating Medicare Enrollment through a spouse.
You may take Medicare benefits through a spouse. Contact your local Social Security office to review your Medicare coordination through your qualifying spouse.
If you’re delaying your Social Security retirement benefit while taking Medicare through your spouse, and later elect to start your Social Security retirement benefit, you should receive a new card. Update your Medicare Supplement plan with the new Medicare ID.
Can I get a spousal benefit through Social Security and my spouse's quarters to qualify for Medicare?
Yes, to qualify for Medicare, you need to have paid into Social Security for 10 years or 40 quarters, or you can qualify under your spouse’s record of quarters paid into Social Security. Many times, in this scenario the spouse is/will be taking Social Security as well as Medicare through the other spouse. The important difference between taking Social Security and taking Medicare through a spouse, is that you must be 65 to qualify for the Medicare portion of benefits through your spouse. I only note this because taking Social Security retirement benefits through a spouse can take place before turning 65. In this situation, the timing of the Medicare benefit for the younger spouse can be mistaken as active when one spouse is over 65 and the other is under 65, yet still taking Social Security retirement benefits through the older Medicare eligible spouse. This isn’t a common mistake, but just a reminder Medicare benefits only start for those 65 and older (unless on Social Security Disability Medicare).
Timing your Social Security benefit and Medicare are separate enrollments, but many times this can overlap and seem complicated when enrolling in Medicare and changing Social Security retirement benefits at the same time. If you have been taking benefits through a spouse (delaying your own benefit) and decide to elect to start your own Social Security retirement benefit at a later date (ie. your Social Security retirement benefit has been building on the side for you as you have been delaying it), remember to update Medicare and your Medicare insurance plan cards because it’s likely your Medicare ID# will be updated under your own benefit and not your spouse’s (you’ll likely get a new Medicare card). Medicare coverage should not be affected. Rather, you’ll be sent a new Medicare ID# to run your own medical billing through.
For more Social Security planning guidance, please refer to the Social Security 101 under Resources tab in the menu or contact my office for one on one advice with John to talk through when its best for you to take your Social Security retirement benefit.
