Urgent! Why Was I Denied Enrollment in Medicare Part B?

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Toni,

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On April 1st, I went to the local Social Security office to apply for my Social Security check and Medicare Part B. I’m turning 70 on April 20th, so I know it’s time to do that. Sadly, on April 11th, I received a letter from Social Security. It stated that the $3,200 Social Security benefit check will be issued on Wednesday, May 21st, to my bank account. To my surprise, the letter also said that I was not approved for Medicare Part B. According to the letter, since I waited past Medicare’s 8-month Special Enrollment Period after retiring on April 30th, 2024, and no longer had employer benefits, I wasn’t eligible.

The letter also urged me to enroll in Medicare Part B during Medicare’s next General Enrollment Period, which, as I’m sure you know, begins January 1st of next year. Forgive my lack of knowledge, but I truly didn’t know there was a specific window of time in which one must apply for Medicare Part B. Truthfully, I thought you could apply for it at any time past 65 years old.

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My COBRA premium is over $800 per month. Can you please explain what I need to do, in simple terms, to enroll in Medicare with a Medicare supplement? I want to enroll in Medicare with a Medicare supplement that is less expensive.

Thanks, Toni,

Gail from Charlotte, NC

lady stressed staring at paper denied medicare

Hi Gail,

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Good news! Page 17 of the Medicare & You Handbook answers your question. The specific Special Enrollment Period (SEP) begins the month after employment ends or the employer benefits end.

Here’s what it says:

“After your Initial Enrollment Period is over, you may have a chance to sign up for Medicare during a Special Enrollment Period. For example, if you didn’t sign up for Part B (or Part A if you have to buy it) when you were first eligible because you have group health plan coverage based on current employment (your own, a spouse’s, or a family member’s if you have a disability), you can sign up for Part A and/or Part B:

Any time you’re still covered by the group health plan
During the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first

Your coverage generally starts the first day of the month after you sign up. If you sign up for Part B while you’re still working, or within the first full month after losing employer coverage, you can request to delay your Part B start date up to 3 months. Usually, you won’t have to pay a late enrollment penalty if you sign up during a Special Enrollment Period. This Special Enrollment Period doesn’t apply if you’re eligible for Medicare based on End-Stage Renal Disease (ESRD), or you’re still in your Initial Enrollment Period.”

Next steps…

Gail, you’re applying for Medicare in April, 11 months after leaving your employer, which is past the SEP 8-month timeline. The letter stated you will have to enroll during Medicare’s General Enrollment Period (GEP), which is from January 1st through March 31st each year. This enrollment period is for those who have never enrolled in Medicare Parts A and B. My advice? Enroll after January 1st of next year to have your Medicare Part B begin on February 1st, 2026.

Until you enroll in Medicare Part B, you will need to remain on your current COBRA plan or visit healthcare.gov to discover what individual health plan you can enroll in, since you are 70 years old.

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What are Medicare’s three enrollment periods?

Medicare enrollment paper with glasses and pen

Did you know that Medicare has three enrollment periods? These are specific time frames in which you can enroll in Medicare. They’re all based on different circumstances, so make sure you pay attention!

Medicare Initial Enrollment Period

Begins 3 months before turning 65, the month one turns 65, and 3 months after one turns 65. Gail, this was NOT your enrollment time because you are past 65.

Special Enrollment Period

Begins after 65 when delaying Medicare Part B, due to working full time with company benefits. This is an 8-month window for enrolling in Part B without receiving a Part B penalty. Gail, this is NOT your enrollment time because you waited past the 8-month window. This could have been your enrollment time if you had enrolled within the 8-month window.

General Enrollment Period

Begins January 1st through March 31st when one has not enrolled in Part B and now can enroll in Medicare Part B, but WILL receive a Part B penalty. Gail, this IS your enrollment time, and you will have to pay a Part B penalty for the remainder of your time on Medicare.

Beginning January 1st, 2023, Medicare’s General Enrollment Period (GEP) (January 1st through March 31st) rules changed to help Americans who had not enrolled in Medicare when turning 65.

Now, when in a GEP enrollment time from January through March, Medicare Part B will begin on the first day of the following month. If one waits past March 31st to enroll in Medicare, Medicare enrollment will be delayed until January 1st of the next year, with a higher Part B penalty. This is your situation, Gail. (More information regarding enrolling in Medicare is available in chapter 1 of Toni’s new Medicare Survival Guide Advanced edition.)

There are many Americans on Medicare receiving a Medicare Part B penalty, costing an average of $5,000 in lifetime penalties because they did not enroll at the right time. Remember, with Medicare, what you don’t know WILL hurt you!”