Missed Part B on Spouse's Small-Employer Plan?
Yes, you likely need Part B as soon as you can enroll. If your spouse's employer has fewer than 20 employees, Medicare is usually primary for you at 65. If you missed your Initial Enrollment Period, check immediately whether a Special Enrollment Period is still available. If not, the General Enrollment Period (January through March) is the next option, and a permanent late-enrollment penalty may apply.
Frequently Asked Questions
- Does it matter that my spouse is still working?
- For employers with fewer than 20 employees, no. Employer size is the controlling factor. Medicare is primary for the eligible spouse at 65, regardless of whether the employed spouse is still actively working.
- Is there any way to get a SEP after missing enrollment on an under-20 plan?
- Possibly, but it depends on whether Social Security considers the under-20 employer coverage to have been qualifying in the first place. Contact Social Security as soon as possible to confirm your options and document your situation.
- How big will the penalty be?
- The Part B penalty is 10% of the standard premium for each full 12-month period since your Initial Enrollment Period during which you could have enrolled but did not. The calculation runs from your IEP, not from when you discover the problem.