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Two people walk inside a Medicare Services office on the last day for enrollment in the Medicare Part D program May 15, 2006 in New York City. You will not face a penalty for signing up for Medicare after age 65 if your employer signs a form indicating you have insurance coverage. Photo by Spencer Platt/Getty Images

Column: Will I be penalized for not getting Medicare at 65? It depends

“Ask Phil,” aims to help older Americans and their families by answering their health care and financial questions. Phil is the author of the book, “Get What’s Yours for Medicare,” and co-author of “Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.” Send your questions to Phil.


Medicare eligibility and signup periods

Patricia – Pennsylvania: I am 72 years old. I work for the City of Philadelphia and plan to work until 75. I have been told I would not be required to take Part B of Medicare (I only have A) until I am retired for six months, even though my city benefits are for five years.

It was suggested that it would be better not to wait the six months because if I had a catastrophic illness, my city insurance would only pay 80 percent of my covered expenses, leaving me with a huge bill. If Part B was in place, it would be my primary insurance and the city’s insurance would be secondary.

However, I also have been told by others that I should have signed up at 65, and I will be penalized from 65 until now. Is this true? If so, both my husband and I have been fed extremely poor information. Please let me know what I am to do and who is giving me the proper information.

Phil Moeller: If you are actively employed and have employer group health insurance, you did not need to get Medicare when you turned 65 and do not need it now, although you could if you thought it would improve upon your existing coverage and was worth the price.

If you didn’t get Medicare at 65, you would not be later charged with late-enrollment penalties, so long as your employer signed this form indicating you’ve had insurance coverage. The form would be presented when you later needed Medicare.

There is an eight-month special enrollment period that begins on the date a person aged 65 or older loses employer coverage. However, your intuition is correct – you should apply for Medicare early enough so that it will have taken effect by the time your employer coverage ends.

It sounds like you will have retiree coverage and Medicare for five years after you stop working. It would be a good idea for you to find out exactly what your retiree plan covers and how it and Medicare would coordinate payment of any covered insurance claims.

People often are reluctant to talk with their insurers, but I’ve found this is usually the best way to get helpful information. My advice is necessarily general in nature as there are lots of different employer plans and I don’t know the details of your plan.


Carol – South Carolina: My husband and I will both turn 65 later this year. We are retired and currently on COBRA from his employer. His employer says I should delay signing up for Medicare for one month. I am reading about all these penalties if you don’t sign up when you become eligible. Should I just sign up in August and pay the COBRA premium as usual? His employer says they will give me a letter and just wait until September when my husband will sign up. I am concerned about that as employer is in a different state and may not understand the rules fully.

Phil Moeller: You should not have to worry about penalties. There is a seven-month initial eligibility period for Medicare, and the start date of your coverage depends on when during this period you enroll.

I always tell people with COBRA that their main concern should not be penalties but making sure they do not have an unintentional lapse in primary health coverage.

Your COBRA insurer, for example, may not continue to provide primary coverage when you turn 65 and would expect Medicare to become your primary insurer then. I urge you to speak with your COBRA insurer to find out if this will be the case.


Survivor benefits

Svet: Before he died last year, my father had 38 of the required 40 quarters of work credits needed to qualify for Social Security benefits. Does my mother have a claim to a portion of my father’s partial Social Security entitlement? If not, can she contribute the two “missing” quarters from her work record to receive the appropriate beneficiary benefit for a widow?

Phil Moeller: If your father died after reaching age 62, there is no basis for your mother receiving a survivor benefit, and the rules do not permit another person to contribute credits to his account. If he died at age 60 or younger, she would qualify for benefits because the agency would adjust the hours needed. Thirty-eight quarters of so-called covered earnings would be enough to qualify for someone who died two years before reaching the earliest age at which benefits normally are available.

Svet: My father passed at the age of 69, so unfortunately it seems that being two credits short of the requirement will be our downfall. Our case is unique because my father worked in the United States for many years under a green card visa prior to becoming a U.S. citizen. I understand that green card holders do not pay Social Security taxes so those quarters of employment under the green card visa did not contribute towards the 40-quarter minimum requirement.

Phil Moeller: I am sorry that your mother apparently does not qualify for a survivor benefit. To make sure, she should ask Social Security for access to his formal earnings record.


Dan – Ohio: I just got done reading “Get What’s Yours for Medicare.” It’s a great source of information and, while Medicare is still confusing, it’s less confusing to me now!

My wife is 73, and I am 64. I will be turning 65 soon. My wife has been taking Social Security benefits since she was 62. I would like to apply for my Social Security benefits when I turn 66. My wife was married before to a man around 35 years ago who has since died. She was married to him for about 12 years. The question is, can she apply for survivor benefits from his account? Another question is whether her benefit will go up when I take Social Security at age 66, and she becomes eligible for a spousal benefit based on my work record. What is the better scenario?

Phil Moeller: If she remarried you when she was age 60 or later, she is eligible for an ex-spousal survivor benefit. If she was younger than this when you married, she is not eligible.

When you apply for your benefit at age 66, she will be eligible for a spousal benefit. If it’s larger than her survivor benefit, she’d receive an additional payment equal to the difference. If not, her benefit would stay the same.


Frank: I’m planning to collect Social Security at age 66 this fall. My wife is nine years younger. Can she collect a spousal benefit? I’m already retired, and she is the breadwinner. We want “What’s Ours!” Thanks for the help.

Phil Moeller: If your wife is the higher earner in your household, she should wait as long as possible to claim her Social Security. She won’t even be eligible to file until she is 62, and benefits rise 7 percent to 8 percent a year between 62 and age 70.

If your wife were to file for a spousal benefit when she turned 62, she also would trigger her own retirement filing at that time. Under new rules passed in late 2015, there is no way she can file for a spousal benefit while deferring her own retirement filing.

READ MORE: How to navigate Social Security’s benefits after marriage, death and divorce

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