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I am 77 years old now and have never enrolled in Medicare because I have been fully insured through my husband's employment all these years. When he finally retires and I go on Medicare will I be penalized for not having enrolled when I was 65?

6

In many cases your employer coverage will grant you a qualified waiver from Medicare and remove your penalty exposure. To start you should call the employer plan administrator, they generally know these things and there are a couple of technicalities that are important that you won't have a way of independently verifying. But, here's the highlights:

In most cases, you don't need to do anything until you (or your spouse) retire or you lose the employer coverage.

Here is the bit about Special Enrollment Periods and penalties:

Special circumstances (Special Enrollment Periods)

Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period (SEP). If you're covered under a group health plan based on current employment, you have a SEP to sign up for Part A and/or Part B anytime as long as:

  • You or your spouse (or family member if you're disabled) is working.
  • You're covered by a group health plan through the employer or union based on that work.

You also have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):

  • The month after the employment ends
  • The month after group health plan insurance based on current employment ends Usually, you don't pay a late enrollment penalty if you sign up during a SEP.

The "based on current employment" part is important. COBRA eligibility is not, to my knowledge, acceptable. I do believe "retiree" specific plans are qualified waivers, the technicality being that a "retiree" is still "currently" eligible for the plan. But, generally, if you or your spouse is working and covered by an group employer you won't have penalty exposure.

There's no cost to Part A and for that reason generally no reason to not enroll when you become eligible if for no other reason than to avoid questions later. When you come off the group plan you should be issued what is commonly called a "HIPAA Certificate" or some other documentation that formally discloses the loss of coverage.

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Yes, if you don’t enroll when you’re first eligible for Medicare, you can be subject to a late-enrollment penalty. You can read the details at the Medicare.gov web site:

Medicare A:

https://www.medicare.gov/your-medicare-costs/part-a-costs/part-a-late-enrollment-penalty

Medicare B:

https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-late-enrollment-penalty

Medicare D:

https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty

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    This does not begin to tell the whole story. In many cases, perhaps including the OP, there is no penalty. – Ben Miller - Reinstate Monica Mar 1 '19 at 20:31
  • Hence the reason for the wording of "You can be" rather than "You will be" subject to a late-enrollment penalty. The starting place to determine which one it will be is the Medicare.gov web site links provided. The OP needs to read the what ifs that pertain to her at the source. If that does not clear it up then contacting Medicare is the next step. – Bob Baerker Mar 1 '19 at 20:59
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    The wording in your answer seems to me to imply that the OP is most likely subject to penalty, when in fact I believe that the OP is most likely not subject to penalty. And, unfortunately, the pages that you are linking to (at least for A & B) do not provide details, either. – Ben Miller - Reinstate Monica Mar 1 '19 at 21:04
  • Concluding that I implied that the OP is most likely subject to penalty is where you went awry. The links clearly state that " Your monthly premium MAY go up 10% ". MAY means it's a possibility. – Bob Baerker Mar 1 '19 at 21:32
  • Yes, but the OP already knows that she may have a penalty, that's why she asked. You haven't provided any new information. – Ben Miller - Reinstate Monica Mar 1 '19 at 22:09

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