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Medicare and Social Security enrollment handled separately

Q: My wife reached age 65 a few months ago but did not sign up for Medicare because she is still working and has insurance from her employer. Is this correct?

A: People can enroll in Medicare without starting Social Security benefits and they can enroll in only part of Medicare if desired.

Social Security and Medicare are separate programs.

Most people enroll in Medicare Part A (Hospital) at age 65 even if still working and having employment based insurance. Part A does not have a monthly premium.

Depending on medical insurance coverage based on the current employment of a worker or his or her spouse, Medicare Part B (Medical) might not be needed at age 65 and can be refused. Part B has a monthly premium.

Before deciding what you should do, check with your employer health coverage.

A person without Medicare Part B because of employer coverage can enroll when they or the spouse whose employment is providing the insurance retires.

Contact Social Security about 2 months before retirement to do this.

People who refused Part B at age 65 because of employer coverage can enroll in Part B when needed and without premium penalty.

Those who refused Part B at age 65 for other reasons can only enroll during annual open seasons, with higher premiums.

While this is general information, if the woman mentioned above has already enrolled in Medicare Part A (Hospital), but not Part B (Medical) because of her employment coverage, this answer should apply. 

If she has not enrolled in any portion of Medicare, she should consider enrolling in at least Medicare Part A now.

Medicare enrollment information, including an online application, is at

Did You Know? The annual publication “OASDI Beneficiaries by State and County (2013)” is at

In it you can learn the number of people receiving Social Security retirement (old-age), survivors and disability benefits in your state and county plus amounts received.

As of December 2013, 18.3 percent of the entire United States population received a Social Security retirement, survivors or disability benefit.

Within North Dakota it was 17.1 percent, Minnesota 17.5 percent, South Dakota 19.3 percent and Montana 20.5 percent.

Dollar amounts are shown in thousands of dollars.

Based in Grand Forks, Howard I. Kossover is the Social Security Public Affairs Specialist for North Dakota and western Minnesota.  Send general interest questions to him at Read his online articles at