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Enrolling in Medicare? Don't get tangled up up in mistakes that are easily avoided.
Enrolling in Medicare? Don't get tangled up up in mistakes that are easily avoided.
Photo: Massimo Gammacurta

When Houston attorney Barbara Quackenbush retired at age 67, she decided to stay on her company health plan through COBRA rather than sign up for Medicare. But as her COBRA coverage neared expiration, she learned that this choice will saddle her with a Medicare penalty requiring her to pay 20% higher premiums.

Even scarier, she'll be left without coverage for 10 months. When Quackenbush found out, she says, "I was so upset I nearly dropped the phone."

Reaching the big six-five is your ticket to guaranteed, affordable insurance via the Medicare system—provided you comply with a byzantine set of rules.

Getting the sign-up process right can be tricky for anyone, but it's become a major headache for the growing number of folks working past 65, say advocates, particularly now that Medicare enrollment no longer comes at the same time people start collecting full Social Security.

"There are pitfalls you must watch out for," says David Lipschutz, a policy attorney at the Center for Medicare Advocacy. Here are four big ones to avoid.

Mistake no. 1: Not enrolling because you're employed.

If you're still working, and have coverage from your job, you don't have to sign up at 65. Many workers, though, benefit from enrolling, especially when you consider that you can take parts A and B at different times.

Who should sign up?

Part A, which covers hospitals, is a no-brainer for most people. It's usually free and may pick up costs your job does not.

If you work for a small company, your firm may require that you take Part B, which covers doctor visits, so that Medicare can start paying most of your expenses. Anyone with a high-deductible plan can also benefit from Part B, since it often picks up costs before you've met the deductible.

A caveat: If you have a health savings account, you must stop making deposits.

Who should hold off on Part B?

Workers at large companies. The plan costs at least $100 a month and often provides little benefit beyond what their job covers.

Mistake no. 2: Failing to sign up when you or your spouse retires.

You must enroll in Part B eight months from your last month of work, even if you have retiree benefits or COBRA. Miss that date and your coverage won't kick in for three to 15 months. You'll also face a 10% premium penalty for every 12 months you delay.

For Quackenbush, going on COBRA for 18 months without enrolling in Part B triggered a penalty and waiting period.

If you're 65 or older and get benefits from your spouse's job, remember that the same rules apply when she retires, says Frederic Riccardi of the Medicare Rights Center: You must sign up within eight months of her final month.

Mistake no. 3: Accidentally voiding retiree coverage.

Signing up for an Advantage plan, which offers coverage as an alternative to parts A and B, could prompt your former employer to kick you off its insurance.

Going with a private Part D plan, which covers drugs, may have the same effect. The reason, says John Grosso, a consultant at Aon Hewitt, is that most retiree coverage is designed to work with traditional Medicare and isn't compatible with private plans.

Mistake no. 4: Not considering Medigap early on.

The first six months after you enroll in Part B is usually the cheapest time to buy a Medigap plan, which covers deductibles and other costs not picked up by Medicare.

People still covered by their job may not need Medigap right away, but if you buy after this six-month period, your monthly premium could jump by $50 or more, especially if you have a health problem. Worse, you could end up being denied.


For more information about the Medicare program, see the Ultimate Guide to Retirement.