Navigating Medicare enrollment

Dear Savvy Senior: I’m planning to work past age 65 and understand Medicare offers initial, special and general periods in which I can enroll. How does this work? — Medicare Illiterate

Dear Medicare: The rules for signing up for Medicare can be confusing, especially if you plan to work past age 65. But it’s crucial to understand them because the consequences of missing a deadline can be costly and last a lifetime. Here’s what you should know about Medicare’s three enrollment periods.

Initial enrollment period

At age 65, this is the first opportunity that most people are eligible to enroll in Medicare.

If you’re claiming Social Security benefits at least four months before age

65, you are automatically enrolled in Medicare, with coverage starting the first day of the month you turn 65. If you’re not receiving Social Security benefits, it’s up to you to enroll in Medicare. Your options are online at ssa.gov/medicare, by phone at 800-772-1213 or through your local Social Security office.

You can enroll anytime during this time, which is a seven-month period that includes the three months before, the month of and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure coverage starts when you turn 65.

If you plan to keep working and have health coverage from your employer or from a spouse’s employer, you may want to delay Medicare Part B, which covers outpatient services, and Part D, which covers prescription drugs. But first check with the human resources department to see how your employer insurance works with Medicare.

Typically, if your employer has fewer than 20 employees, Medicare will be your primary insurer and you should enroll. But if you work for a company that has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you remain an active employee. If this is the case, you don’t need to enroll in Part B or Part D when you turn 65 if you’re satisfied with the coverage through your job. But in most cases, unless you’re contributing to a Health Savings Account, you should at least sign up for Medicare Part A, which is free and covers hospital services.