Medicare enrollment complicated by the pandemic

As an increasing number of Americans continue to work beyond the traditional retirement age of 65, many have delayed enrolling in Medicare as they continue to enjoy employer-subsidized health insurance. But now that more than a million older workers have lost their jobs — and their health insurance — many are finding that trying to enroll in Medicare during a pandemic is complicated.

The unemployment rate among people age 65 and older quadrupled between March and April, from 3.7% to 14.7%, according to the Kaiser Family Foundation. More than 1.2 million adults age 65 and older lost their jobs in March and April and in many cases, their health insurance, too.

Although this group of unemployed workers is eligible for Medicare, delayed enrollment after age 65 is normally handled by visiting one of the local Social Security field offices, which have been closed to the public since March 17 as a result of the pandemic. Medicare is managed by the Centers for Medicare and Medicaid Services, but the Social Security Administration processes the applications.

“We have seen an increase in calls from people who have lost their jobs and are looking to go on Medicare,” said Frederic Riccardi, president of the nonprofit Medicare Rights Center, which fields more than 20,000 questions a year through its free consumer helpline (800-333-4114).

“People are calling because they are confused about how to enroll in Medicare,” Riccardi said. “It is really important to sign up for Medicare as soon as possible to avoid any gaps in coverage and lifetime late enrollment penalties.”

Most people can use the online application to apply for Medicare to enroll in Parts A and B during their initial enrollment period, which begins three months before their 65^th birthday, includes their birthday month and extends three months after their 65th birthday.

Medicare Part A covers in-patient hospital costs and is premium-free to anyone who has earned the minimum of 40 quarters of coverage and paid FICA taxes during at least 10 years of covered employment. Spouses are also eligible for premium-free coverage. Medicare Part B covers outpatient services and has a monthly premium, currently $144.50 per month in 2020. High-income beneficiaries pay more.

Many people enroll in Part A at 65, even if they continue to work, because it is premium-free.

In most cases, people who miss enrolling in Medicare Part B during their initial enrollment period face lifelong delayed enrollment penalties of 10% per year for every year they were eligible to enroll but did not.

But there is one major exception to the Medicare Part B signup rule: continued group health insurance coverage through a current employer or through a spouse’s current employer. People who have “creditable” group health insurance can delay enrolling in Medicare penalty-free for up to eight months after that employer coverage ends by taking advantage of a special enrollment period.

The challenge is how to sign up for coverage during a special enrollment period when the Social Security offices that take the applications are closed.

The Social Security Administration offers the following guidance:

“If you are already enrolled in Medicare Part A and you want to enroll in Part B, you cannot use our online application. Please mail your completed application form for enrollment in Medicare Part B Medical Insurance to your local Social Security field office. You can find the address and phone number for your local office based on your zip code at https://secure.ssa.gov/ICON/main.jsp."

Normally if you are applying for Medicare Part B as part of a special enrollment period as a result of losing group health insurance, your employer has to attest that you had creditable health insurance during the previous eight months. Given the pandemic, federal officials are allowing applicants to fill out that form on behalf of their employer and submit proof that they had health insurance, such as income tax returns that show health insurance premiums paid, W-2s reflecting pretax medical contributions or pay stubs that list health insurance premium deductions.

The Medicare Rights Center recommends that you send your paperwork to your local Social security office by certified mail so you will have a receipt and confirmation that your form was delivered in case you encounter any problems with your enrollment. If you speak to anyone at your local office, record the name of the representative you speak to and the date and time of the conversation. And if you experience difficulties with your local Social Security office, such as being told your enrollment cannot be processed, ask to speak to a supervisor. If that doesn’t resolve the problem, contact your congressman for help.

There is another complicating factor when it comes to losing a job and employer-provided health insurance. In some cases, unemployed workers can continue their group health insurance for 18 months under COBRA, usually paying the entire cost of the premium, both the employer and the employee portion. But COBRA and retiree health plans aren’t considered coverage based on current employment. You must sign up for Medicare Part B within eight months of losing employer-provided health insurance — not eight months after your COBRA coverage ends — to avoid delayed enrollment penalties.

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