Hello Toni:
I need your help about enrolling in Part B or delaying it. I am self-employed with no employees, turning 65 with an individual Blue Cross/Blue Shield health plan that covers me and my wife. I’ve been told by friends that since I am still working, paying taxes quarterly and have health insurance that I do not need Part B. Do I need to sign up for Medicare or what?? I do not want to make a big mistake. Please explain. God Bless You for all of the help you give to those “Confused about Medicare”…Bill a West University Examiner reader
Hello Bill:
Great Medicare question, Bill…Last week, I consulted with a person that is also self-employed, but was given wrong advise from a well-meaning friend about delaying his Part B. His Medicare nightmare is now starting…Medicare does not recognize individual plans as creditable cover for delaying your Part B. Now this fellow who is 66 will receive not only a 10% penalty for each year due to not enrolling in Part B at the right time, but a 20% penalty (2 years 65 and 66) each month for as long as he is on Medicare or should I say the rest of his life. The 20% penalty goes up as the Part B premium changes. Stinks doesn’t it!!
Since you currently have an individual health insurance plan, I would recommend that you enroll in Part B during your “Initial Enrollment Period”. Many think that Medicare is automatic and this is only true if you are receiving Social Security when you turn 65. If you are not receiving Social Security, you will need to proactively sign up for Medicare 3 months before your 65th birthday. You can do this by either calling Social Security at 1/800-772-1213 or online at www.socialsecurity.gov.
The average person is simply confused about denying Part B and how many employees are working for the company. Since you and your wife are self-employed the rule is different because there is only 1 employee. But if your wife did work for a company with employees here is what the rule says.
Below is the rule about the number of employees and enrolling in Medicare:
Note: Medicare rule on number of employees when one is enrolling or not enrolling in Part B depends on either over/under 20 employees.
a) If there are 20 or more employees at the company, where you or your spouse currently work and receive benefits, generally the company health insurance is primary. It may be to your advantage to delay Part B enrollment. Since you are self-employed and maybe your spouse “works” for a company that has over 20 employees, then you might be able to enroll or stay with your spouse’s health plan. As I said earlier it might be to your advantage to deny Part B for a later time. (Always check with Social Security and HR when delaying Part B.)
When you leave the company’s health plan and must enroll in Part B because either you or your spouse are no longer “working”, call Social Security or you should go in the office, ask Social Security for a SEP (Special Election Period). Remember; always get copies for your records of what Social Security is processing for you.
b) If there are fewer than 20 employees at the company where you or your spouse currently work, and get benefits, generally Medicare is primary. You should not delay enrollment into Part B. If you decline Part B, you may have no primary insurance, which is usually like having no insurance at all. (Always check with Social Security and HR when delaying Part B.)
Toni King is an advocate/consultant for those “Confused about Medicare”. Email questions to asktoni@medicaretruths.com or call 281/830-3896. Visit her website www.medicaretruths.com. Seeking comments about how Healthcare Reform has affected your Medicare.
