Dear Savvy Senior
I’ll be turning 65 this fall and I’m planning to work for a few more years. Do I have to sign up for Medicare if I am still working and receiving health insurance through my employer?
Working Retiree

Dear Retiree
The rules for enrolling in Medicare can be confusing. But when you postpone retirement past age 65, as many people are doing these days, it becomes even more complicated. Here’s what you should know.

The basics
Let’s start with a quick review. Remember that traditional Medicare has two parts: Part A, which provides hospital coverage and is free for most people. And Part B, which covers doctor’s visits and other medical services and costs $115.40 per month for new enrollees in 2011.
If you’re collecting a Social Security check, your Part B premium will be deducted automatically every month. If you are waiting to collect Social Security, however, your Part B premium will be billed to you quarterly.

Enrollment rules
If you plan to continue working past the age of 65 and have insurance from your job, your first step is to ask your benefits manager or human resources department how your employer insurance works with Medicare. In most cases, you should at least take Medicare Part A because it’s free. But to decide whether to take Part B or not, will depend on the size of the company you work for.
If there are fewer than 20 employees in the company, Medicare will be your primary insurer and you should enroll in Medicare Part B during your initial enrollment period – a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. You can sign up online at socialsecurity.gov, or call 800-772-1213.
If you miss the seven-month sign-up window, you’ll have to wait until the next general enrollment period, which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium.
If, however, there are 20 or more employees in your company, your employer’s group health plan will be your primary insurer. If this is the case, you don’t need to enroll in Part B when you turn 65 if you’re satisfied with the coverage you are getting through your job. But if you do decide to enroll in Medicare, it will supplement your employer insurance by paying secondary on all of your claims.
In most cases, you should probably not drop employer coverage for Medicare. If you choose to take Medicare and drop your employer insurance, it may be very difficult for you to re-enroll in your employer plan should you decide to do so later.
In either case, you’ll qualify for a special enrollment period, which will allow you to enroll in Medicare without penalty as long as you sign-up within eight months after you lose your group health coverage or you stop working, whichever comes first.

Drug coverage
You also need to verify your prescription drug coverage. Call your benefits manager or insurance company to find out if your employer’s prescription drug coverage is considered “creditable.” (Creditable prescription drug coverage is one that is considered to be as good as or better than the Medicare prescription drug benefit.)
If it is, you don’t need to enroll in a Medicare Part D prescription drug plan. If it isn’t, you should purchase a plan during your initial enrollment period or you’ll incur a premium penalty (1 percent of the average national premium for every month you don’t have coverage) if you enroll later.

Savvy Tips: For additional help, call Medicare at 800-633-4227 or contact your State Health Insurance Assistance Program (see shiptalk.org or call 800-677-1116) who offers free Medicare counseling. The Medicare Rights Center is another great resource that provides assistance at 800-333-4114.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.