Turning 65
"Enrollment Review"
Start planning for your Medicare enrollment period.
Directions for Turning 65 Medicare enrollment in 2022
Where to begin? Are you turning 65 soon? Let’s simplify the choices you have when closing in on turning 65 and starting your Medicare coverage. Medicare can be complicated, but with the following instructions, you should be able to clearly choose which enrollment period to use (IEP or SEP). The resources of MedicareSupplementMentor.com are designed to that help you make confident decisions when turning 65 and/or when transitioning to Medicare for the first time. If If you have questions, contact my office or please take advantage of the Medicare Toolbox and Medicare Video Library which are designed to clarify “all things Medicare”.
In addition to your Medicare coordination with Social Security, I have clearly defined the various enrollment windows for Medicare Supplement Plans, Medicare Advantage Plans, and Medicare Prescription Drug Plans for IEP and SEP conditions– go to Medicare Insurance Plan Enrollment Periods.
Turning 65 Medicare Birthday Month?
What month do you turn 65? You’re likely looking into your Medicare enrollment and the insurance plan options somewhere between 3-6 months before your 65th birthday. However, you may still be working and/or wondering the best way to approach Medicare enrollment when working past 65. Let’s clear up which direction you should head depending on your specific situation. Let’s use a hypothetical birthday month, so you can apply the same principles used in this example to your own 65th birthday.
Example: 65th Birthday in the month of June – June 15th to be specific.
Medicare Enrollment Period - IEP when turning 65
3 months before
First day - March 1st
Apply 1-3 months before
3 months after
Last day - September 30th. Medicare Start dates may vary.
Currently retired or retiring before your 65th birthday without employer health plan coverage. Medicare coverage start date - 1st of your 65th birthday month.
If this sounds like you, you’ll be using your Initial Enrollment Period or IEP to start your Medicare coverage. When you enroll into Medicare at ssa.gov online or a your local Social Security office, you’re able to enroll 3 months before your 65th birthday month. Using the example above (June 15th birthday) and you are currently receiving Social Security retirement benefits, Social Security will automatically enroll you for a June 1st start date using the IEP approximately 3 months before June and mail you Medicare cards. If you are delaying your Social Security retirement benefits, you will need to proactively enroll in Medicare within the 3 month period before turning 65 for a June 1st start date using IEP (March 1- May 31st).
Again, using the example of turning 65 with your birthday is on June 15th, you would be eligible to use your IEP from March 1- May 31st for a June 1st Medicare start date. See chart below for when Medicare would start if applying the month of, or 1-3 months after your birthday month, without employer group coverage. If you have employer coverage, and do not intend on retiring/enrolling surrounding your 65th birthday, scroll lower and learn more about your SEP Part B enrollment window.
Now that you have your Medicare/ Part B date established, use my Medicare Toolbox and open Medicare Insurance Plan Enrollment Periods to explore the Medicare insurance options you can add during the 3 months before turning 65– again, planning for everything to begin on June 1st (hypothetical 65th birthday month). Yes, Medicare coverage will begin on the 1st of the month you turn 65, even though you are not technically 65. If you happen to have a birthday on the 1st of the month, you are eligible to start Medicare and get coverage the month before your 65th birthday (i.e. May 1st birthday, Medicare coverage can start April 1st).
Working past 65 and/or covered under an employer group health plan - applying for Medicare outside your IEP and using SEP for Part B activation.
So you’re turning 65 soon, but not ready to start Medicare? This is very common. Maybe you’re still working and have coverage under your work’s employer group plan and don’t plan on retiring until 67 or 68? Maybe you have employer coverage through a spouse who is still working and you’re planning to make the transition to Medicare when he/she turns 65 and both of you can go on Medicare. Also, a very common scenario. You will using what is called a Special Election Period or SEP to start your Medicare.
Don’t over complicate this situation. As long as you are working and have continuous creditable employer group plan coverage, you can delay the start of your Medicare Part B and Part D (penalty-free with creditable coverage) until the month you want it to begin. With that said, I get that understanding the path to accurately starting your Medicare coverage can be reassuring to know ahead of time. Having this foundation of knowledge will allow you to understand your SEP enrollment window, how to apply, and why you’re able to start Part B, and Part D without a penalty as you consider when you’d like to retire and transition to Medicare.
Once you’re past the 7 month IEP window surrounding turning 65, age doesn’t play a part in your Medicare enrollment. Hence the use of the SEP window, which you can time for a seamless Medicare transition while you’re still covered under the employer group plan.
How to use the employer Special Election Period or SEP to start Medicare after turning 65 with current employer group coverage within 8 months.
Fill out form 40B and form L564– use both CMS forms to start Medicare by submitting them to Social Security. Using these forms within an 8 month window of current employer coverage will allow you to enroll in Part B of Medicare (Part A will follow along as well, don’t worry). If you’re still working and haven’t paid Part B Medicare premiums because you didn’t need it with your employer group plan after turning 65– you’ve technically delayed Part B of Medicare. Now, let’s reinstate Medicare, and make it effective the 1st of the month after leaving the employer group plan (you want no lapse in coverage, right?) and without a penalty. Submit the 40B and L564. Indicate in the month you want Part B to begin under the remarks section on CMS form 40B. I recommend writing out the date– specifying when you want it to start.
To illustrate, let’s say I have a client retiring at some time in the month of August at 68 years old. He/she is obviously way outside their window to use the Initial Enrollment Period when turning 65. He/she wants Medicare to start the day after their employer group plan ends on August 31st (coverage ends the last day of the month you leave the group employer plan). In May/June, he/she submits form 40B and L564 to Social Security, indicating on 40B, the requested effective date of 09/01/2023. The client’s employer filled out the L564, showing creditable coverage from the day he/she started working for the company, and indicated that the client was still currently covered under the employer group plan.
The client sent in the 40B and L654 about 2-4 months before August knowing he/she was planning to retire in August. Doing this ahead of time gave Social Security plenty of time to process the request. The request for Part B of Medicare to start 09/01/2023 using their Part B SEP to avoid a lapse in coverage as well as avoid the penalties. Their SEP submission was then approved by Social Security and made effective 09/01/2023. During the same 2-4 months before August 31st, the client worked with me to find the Medicare insurance plan(s) to start 0n 09/01/2023.
If you decide to retire and transition to Medicare while having creditable employer group coverage on a shorter timeline, such as a week or two before you need Medicare to begin, you can still get it started the 1st of the next month. I recommend handing in the paperwork in-person, or faxing it to a specific office in your city and calling the office to confirm receipt of forms 40B and L564. It is always best to get confirmation in paper form if possible as well as a dated stamped copy to confirm the submission date.
The Social Security office should date stamp the approval for proof of when the paperwork was submitted. Doing so prior to the requested effective date, will allow you to proceed with Medicare insurance enrollment even though you my not have the Medicare cards in hand as the paperwork was submitted on short notice. You will still have active coverage without the cards in hand.
Medicare Enrollment Period - SEP leaving employer plan
8 month SEP window - currently covered
Submit 40B & L564 (ie. May-Aug). Employer coverage through hire date to now-- still currently covered.
Retiring in August- coverage ending
Last day of the month
August 31st - no lapse in coverage
Medicare effective start date
First day of next month. September 1 - no Part B or Part D penalty (show credible coverage.
To summarize the example above, this client had been working a few years past their 65th birthday. They needed to show proof of current employer group coverage within 8 months to qualify for the SEP window (creditable coverage CMS- form L654) This proof is the employer signed form, also known as L564, which is sent along with 40B to start Medicare on the day indicated on the form. Again, clearly write the requested Part B start date under “remarks” on 40B form.
Within a one or three month window of time before the SEP September 1st start date (remember, he/she retired in August) and while the 40B and L564 is being processed, the client contacted me, John Crump, broker and principal of Mentor One Insurance Solutions. I worked one-on-one with the client, reviewing potential Medicare insurance plans to begin 09/01/2022. Having this all figured out prior to August makes the transition to Medicare much more seamless for my client.
Contact my office. I’ll help talk you through your specific IEP or SEP enrollment. Whether you’re turning 65 soon (IEP), or starting Medicare at a later time through an SEP at say, 67 or 70, I can help with all aspects of your enrollment.
