For anyone approaching 65
What happens at 65
Turning 65 starts a clock, whether or not you plan to retire. Missing it can add a cost to every month for the rest of your life. Here is what to watch for, and when.
The three numbers
Three deadlines, and none of them move
- Months around your birthday
Three months before your birthday month, the month itself, and the three months after. Sign up in the three months before and coverage can start when you turn 65. Leave it later and it starts later.
- Months after group coverage ends
If you work past 65 and stay on your employer’s plan, a second window opens when that coverage ends. Usually retirement — but also dropping below the hours that qualify you for benefits.
- Days to sort out prescriptions
Once drug coverage that counts as “creditable” ends, you have 63 days to pick up Part D. After that a late charge attaches, and it does not come off.
These are two separate clocks, not one long runway. They might open in the same month. They might be ten years apart.
Which clock is yours
It turns on one question you can ask HR
How many people does the company employ? Your HR department can answer that in a sentence, and it decides which of the two clocks applies to you.
Fewer than 20 employees
Medicare generally pays first once you turn 65, and the employer plan pays second — whether or not you have enrolled. If you skip Part B, the share Medicare would have covered may go unpaid, and that bill can find its way back to you. People in this situation generally need to enroll at 65 even though they are still working.
20 or more employees
The employer plan generally pays first while you are actively working, and Part B can usually wait without a late charge. The eight-month clock is the one that matters, and it does not start until you stop working.
If the company is near the line, or uses a PEO or a multi-employer plan, ask rather than assume.
What catches people out
Four things worth knowing before the window opens
Open any that sound like your situation.
A health savings accountIf you apply for Medicare or Social Security after 65, Part A can be backdated up to six months.
Contributions made during that backdated stretch become a tax problem. Contributions generally need to stop about six months before you apply.
COBRA is not the same as working coverageElecting COBRA at 65 does not hold your Part B window open.
People find this out after it has already closed. Retiree coverage does not hold it open either — only coverage based on someone’s current employment does.
A younger spouseIf a spouse or dependent is on the employer plan through you, their coverage may end when yours does.
Check this before you decide anything. It is the detail found too late most often, and it can turn a straightforward retirement into a scramble.
The late charge is permanentPart B adds roughly 10% for each full year you could have enrolled and did not.
It is charged every month, for as long as you have Part B. It is not a one-time fee and it does not come off later.
What to do now
Four things, none of which cost anything
Ask HR how many people the company employs
One question. It decides which clock you are on, and it is the only fact on this page you cannot work out for yourself.
Put your seven-month window in your calendar
It opens three months before your birthday month. Knowing the date is most of the work.
Find out what happens to anyone on your plan
If a spouse or dependent has coverage through you, ask what happens to them when you move to Medicare — before you decide anything.
If you contribute to an HSA, work out your stop date
Roughly six months before you expect to apply for Medicare or Social Security.
Ask your questions before the window opens, not during it.
About your HR department
Your HR department can tell you these windows exist and point you toward someone who can explain them. They are not allowed to recommend a plan or tell you whether to enroll. That is not unhelpfulness — it is the rule they work under.
Where to get help
All three of these are free
Utah SHIP
The state’s free Medicare counseling program. Independent, no products, no sales, no cost.
1-800-MEDICARE
Medicare’s own line, any hour of the day.
James Briggs
I will sit down with you at no cost and go through what applies to your situation, whether or not you are retiring. There is no obligation and nothing is sold at that conversation.
Your employer pays me nothing. If you decide on your own to enroll in a plan through me, the carrier pays a commission set by that plan, and your cost is identical either way. If you would rather use SHIP or go elsewhere, I will tell you how.
Ask a question
If something here applies to you, ask
A question by email, or twenty minutes on the phone. Whichever is easier. There is no cost and no obligation, and I will tell you if the answer is that you should call SHIP instead.
Send a question
Whatever you are trying to work out. I answer these personally.