What Is Medicare Special Enrollment Period for Working Aged?

SEP eligibility can be delayed for existing conditions; recipient or spouse are 65 or over and continue to work, Medicare recipient may be eligible at a later date.

Recipient or spouse continue to work, covered under the employer’s group health plan. The retired Medicare recipient over the age of 65 returns to work and is covered by an employer’s group health plan. Or the employee is under 65 and the Medicare recipient over 65 is covered through a group health plan. Recipient is disabled and working or is covered under a working family member’s group health plan the SEP rules may still apply.

Eligibility Enrollment

Medicare recipients 65 or older who continue to work and are covered under an employer’s group health plan have the option to enroll. If the recipient is within 8 months following the month when the employer’s insurance coverage ends or the employee retires. During the Medicare Special Enrollment Period a surcharge does not apply if a written request to delay Part B was submitted.


If recipient is working and plans to keep the employer’s group plan, enrollment in Part B needs coordination. Part B, Medigap open enrollment is automatic; once it begins it cannot be changed. When the recipient is eligible for SEP and does not sign up, recipient will be able to sign up during the Part B general enrollment, subject to higher costs.

If recipient drops Part B because recipient, spouse or family member (if recipient are disabled) returned to work with group health coverage, recipient can sign up during the special enrollment period without a higher cost to Part B. However, recipient may not get Medigap automatically when recipient restarts Part B. Make sure your group coverage is in effect before you drop Part B.

Comments are closed.