SLEDGE: On obtaining Medicare prior to entering retirement

Q: I can’t receive my full Social Security until age 66. But I’ve heard that I can get still Medicare at age 65. Is this true, and how do I get the Medicare benefits? — Charlotte

A: Charlotte, you’re right that, despite the increase in full retirement age, the age of earliest entitlement to Medicare is still 65. (There are separate entitlement requirements, though, for those who are receiving disability benefits or who have permanent kidney failure.) These days a good many folks want to defer their entitlement to retirement benefits until they’ve reached full retirement age so they can receive the unreduced benefit amount, but often they still want their Medicare to begin at 65. This requires two applications — one just for Medicare and a second later on for the retirement benefit. We recommend applying about three months in advance for either of these benefits. The best way to file for retirement benefits nowadays is online at http://www.socialsecurity.gov, but at present there is no online Medicare-only application. For that, we recommend instead that calling the toll-free number (1-800-772-1213) and make an appointment. You can even arrange to have the interview done by phone.

Here’s an important point to bear in mind, though, for those contemplating filing for Medicare first and retirement benefits later: if you’re planning to continue working after age 65 and you have health insurance through your employer — or if you’re covered on a spouse’s employer-based health plan and your spouse is going to continue working after you reach age 65 — that insurance will be the primary source of your health coverage. Medicare will be secondary, to help pay for those medical expenses not covered by the employer’s plan. This becomes an important matter when you consider that you pay no premium for Part A of Medicare (the hospital insurance), but that Part B (the medical insurance, or “doctor’s insurance”) currently has a monthly premium of $96.40, regardless of whether the coverage is primary or secondary.

Now normally there’s a defined enrollment period during which you have to apply for Part B or risk facing a delay in coverage and even having a penalty for late filing added to your premium. This initial enrollment period is a seven-month block of time that includes the three months before the month you turn 65, the month you turn 65, and the three months after the month you turn 65. But when Part B is going to be secondary due to employer-based health insurance while you or your spouse continue to work, the law permits you to decline Part B at 65, enroll in just Part A (secondary, but a premium-free secondary), and then pick up Part B later, when you (or your spouse) stop working or the employee health coverage ends, whichever occurs first. That’s when Medicare will become the primary source of health coverage, and at that point you’ll be given a special enrollment period (an 8-month period that begins the first full month after employment or group health plan coverage ends); entitlement can begin with the first month following the last month of work or employer-based health insurance, so there’s no break in health coverage; and there’s no late-filing penalty added to the premium.

You can get a lot more information on this topic by going to the Frequently Asked Questions at http://www.socialsecurity.gov and clicking on the topic “Medicare.”