Under-20 Employer Coverage? Check Part B SEP Risk
Do not assume the SEP solves the problem. Active employer coverage may support a Part B SEP, but when the employer has fewer than 20 employees, Medicare is usually primary at 65 and many small-employer plans expect you to enroll in Part B. Confirm your situation with Social Security, Medicare, and the plan's benefits administrator quickly.
Frequently Asked Questions
- Can I still get a SEP after losing under-20 employer coverage?
- It depends on whether the coverage was qualifying. Under-20 employer plans generally do not qualify for penalty-free delay because Medicare is primary. Social Security may determine no valid SEP applies. Confirm your situation quickly — time matters.
- What if I was actively working when I lost the coverage?
- Active employment is necessary but not sufficient. The employer must also have had 20 or more employees. Under-20 active-employer coverage usually does not protect you from the Part B penalty.
- How quickly do I need to act after losing the coverage?
- Act immediately. If any SEP is available, it typically lasts 8 months from when employment or coverage ends. Waiting reduces your options and may let the window close.