Medicare Blog

can my employer require me to sign up for medicare when i turn 65

by Dr. Godfrey Waters Published 2 years ago Updated 1 year ago

If you work at a small employer plan, your employer is permitted to require you to get Medicare when you turn 65. At that time, Medicare will become your primary health insurer. Your employer also has the option to cancel your workplace plan or retain it as a secondary payer of covered insurance claims.

If you work at a small employer plan, your employer is permitted to require you to get Medicare when you turn 65. At that time, Medicare will become your primary health insurer. Your employer also has the option to cancel your workplace plan or retain it as a secondary payer of covered insurance claims.Oct 10, 2018

Full Answer

Do I have to sign up for Medicare at 65?

If the employer has less than 20 employees: You might need to sign up for Medicare when you turn 65 so you don’t have gaps in your job-based health insurance. Check with the employer. If you have COBRA coverage: Sign up for Medicare when you turn 65 to avoid gaps in coverage and a monthly Part B late enrollment penalty. If you have COBRA before signing up for Medicare, …

Can my employer require me to sign up for Medicare?

Mar 03, 2020 · The answer depends on the size of the company sponsoring the group health plan. If the company has 20 or more employees, it must offer the same coverage to those 65 years or older as it does to younger employees. It cannot force employees to enroll in Medicare or offer any incentives to do so.

Can I enroll in Medicare Part B If I'm 65?

Medicare will not force you to sign up at 65, and you’ll get a special enrollment period to sign up later as long as you have a group health plan and work for an employer with 20 or more people. It’s generally advisable to stop HSA contributions six months prior to signing up for Medicare if you’re enrolling after age 65 because retroactive coverage is automatic in that situation.

Can I delay Medicare enrollment if I'm over 65?

Feb 01, 2021 · Technically, it is not mandatory to sign up for Medicare at 65 or at any age, for that matter. But it’s important to consider the situations in which you might decide not to enroll in Medicare at 65 so that you can make sure not to have any lapse in health insurance coverage or face a Medicate late enrollment penalty.

Are you forced to go on Medicare?

Strictly speaking, Medicare is not mandatory. But very few people will have no Medicare coverage at all – ever. You may have good reasons to want to delay signing up, though.

Are you automatically signed up for Medicare when you turn 65?

Yes. If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. (Medicare is operated by the federal Centers for Medicare & Medicaid Services, but Social Security handles enrollment.)

What happens if you don't enroll in Medicare Part A at 65?

If you don't have to pay a Part A premium, you generally don't have to pay a Part A late enrollment penalty. The Part A penalty is 10% added to your monthly premium. You generally pay this extra amount for twice the number of years that you were eligible for Part A but not enrolled.

Can I choose not to enroll in Medicare?

If you do not want to use Medicare, you can opt out, but you may lose other benefits. People who decline Medicare coverage initially may have to pay a penalty if they decide to enroll in Medicare later.

Do I need to notify Social Security when I turn 65?

Is it automatic when I turn 65? To enroll in Medicare, most people need to contact Social Security directly. Do this before your 65th birthday to avoid a lapse in health coverage.Sep 15, 2013

What documents do I need to apply for Medicare?

What documents do I need to enroll in Medicare?your Social Security number.your date and place of birth.your citizenship status.the name and Social Security number of your current spouse and any former spouses.the date and place of any marriages or divorces you've had.More items...

How does working affect Medicare?

Generally, if you have job-based health insurance through your (or your spouse's) current job, you don't have to sign up for Medicare while you (or your spouse) are still working. You can wait to sign up until you (or your spouse) stop working or you lose your health insurance (whichever comes first).

How do you pay for Medicare Part B if you are not collecting Social Security?

If you have Medicare Part B but you are not receiving Social Security or Railroad Retirement Board benefits yet, you will get a bill called a “Notice of Medicare Premium Payment Due” (CMS-500). You will need to make arrangements to pay this bill every month.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.Jan 3, 2022

What parts of Medicare are mandatory?

There are four parts to Medicare: A, B, C, and D. Part A is automatic and includes payments for treatment in a medical facility. Part B is automatic if you do not have other healthcare coverage, such as through an employer or spouse.

When did Medicare Part D become mandatory?

2006Under the MMA, private health plans approved by Medicare became known as Medicare Advantage Plans. These plans are sometimes called "Part C" or "MA Plans.” The MMA also expanded Medicare to include an optional prescription drug benefit, “Part D,” which went into effect in 2006.Dec 1, 2021

Do you have to take Medicare if you take Social Security?

No, it isn't mandatory to join Medicare. People can opt to sign up, or not. If you don't qualify for Social Security retirement benefits yet, you may need to manually enroll in Medicare at your local Social Security office, online or over the phone when you turn 65.Jan 20, 2022

What is Medicare secondary payer?

Medicare secondary payer (MSP) laws dictate that a group plan sponsored by a company with fewer than 20 employees becomes the secondary payer. Medicare would be primary, which means that enrollment in Part A, hospital insurance, and Part B, medical insurance, is necessary.

Do 65 year olds need to enroll in Medicare?

The 65-year old employees would need to enroll in Part A, and Part B during the Initial Enrollment Period. The group health plan would help pay for eligible expenses that Medicare didn’t cover. If the plan’s drug coverage was creditable (meaning paying at least the same as a Part D plan would), there would be no need to enroll in ...

What happens if you don't sign up for Medicare?

Specifically, if you fail to sign up for Medicare on time, you’ll risk a 10 percent surcharge on your Medicare Part B premiums for each year-long period you go without coverage upon being eligible.

How long does it take to get Medicare?

Learn how to make sure they have health insurance once you’re enrolled. Medicare eligibility starts at age 65. Your initial window to enroll is the seven-month period that begins three months before the month of your 65th birthday and ends three months after it. Seniors are generally advised to sign up on time to avoid penalties ...

Does Medicare pay for Part A?

That said, it often pays to enroll in Medicare Part A on time even if you have health coverage already. It won’t cost you anything, and this way, Medicare can serve as your secondary insurance and potentially pick up the tab for anything your primary insurance (in this case, your work health plan) doesn’t cover.

Do You Have to Sign up For Medicare if You Are Still Working?

The most common reason for people not signing up for Medicare when they turn 65 is because they are still working. Because they’re still working, they’re likely covered under their employer’s health insurance plan and are also unlikely to be collecting Social Security retirement benefits.

Can I Get Social Security and Not Sign up for Medicare?

Yes and no. Medicare Part B is optional. If you’re automatically enrolled in Medicare Part A, you will be automatically enrolled in Part B and then given the option of opting out. You may still continue to receive your Social Security benefits without having Part B.

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How does Medicare work with my job-based health insurance when I stop working?

Once you stop working, Medicare will pay first and any retiree coverage or supplemental coverage that works with Medicare will pay second.

When & how do I sign up for Medicare?

You can sign up anytime while you (or your spouse) are still working and you have health insurance through that employer. You also have 8 months after you (or your spouse) stop working to sign up.

Do I need to get Medicare drug coverage (Part D)?

Prescription drug coverage that provides the same value to Medicare Part D. It could include drug coverage from a current or former employer or union, TRICARE, Indian Health Service, VA, or individual health insurance coverage.

How long does Medicare enrollment last?

The general rule for Medicare signup is that unless you meet an exception, you get a seven-month enrollment window that starts three months before your 65th birthday month and ends three months after it. Having qualifying insurance through your employer is one of those exceptions. Here’s what to know.

How much is the penalty for Part D?

For Part D, the penalty is 1% of the base premium ($33.06 in 2021) multiplied by the number of full, uncovered months you didn’t have Part D or creditable coverage.

Who is Elizabeth Gavino?

“I find it is always good to just confirm,” said Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans.

Does Medicare have a premium?

Part A has no premium as long as you have at least a 10-year work history of contributing to the program through payroll (or self-employment) taxes.

Do you have to sign up for Medicare at age 65?

Medicare may not be top of mind if you’re nearing the eligibility age of 65 and already have health insurance through your employer. However, it probably deserves some attention. While not everyone must sign up, many are required to enroll unless they want to face life-lasting late-enrollment penalties.

Medicare vs. employer insurance

Whether you must enroll in Medicare when you’re eligible or face late penalties depends on the size of the company sponsoring the group health plan. In addition, the employed person (you or your spouse) must be actively employed. If the group health insurance is through a retirement plan, Medicare is always the primary payer.

What are primary and secondary coverage?

As discussed above, if you turn 65 and are still working, you need to understand whether employer coverage or Medicare is primary or secondary. Primary coverage pays for eligible claims first, and secondary coverage helps pay the remaining amount.

Can you have Medicare and employer insurance?

Yes, you can have Medicare and employer insurance. When deciding which health insurance option is best for you, consider asking your employer plan provider the following questions:

Is Medicare mandatory when you turn 65?

Medicare is not mandatory when you turn 65, though whether you must pay a late enrollment penalty when you do sign up depends on a number of circumstances.

When should I enroll in Medicare?

In most cases, you should enroll in Medicare when you first become eligible. This is called your Initial Enrollment Period. It lasts through the 3 months before the month you turn 65, the month you turn 65, and the 3 months after your birthday month.

What happens if you don't have Part B insurance?

If you don’t, your employer’s group plan can refuse to pay your claims. Your insurance might cover claims even if you don’t have Part B, but we always recommend enrolling in Part B. Your carrier can change that at any time, with no warning, leaving you responsible for outpatient costs.

What is CMS L564?

You will need your employer to fill out the CMS-L564 form. This form is a request for employment information form. Once the employer completes section B of the form, you can send in the document with your application to enroll in Medicare.

Who is Lindsay Malzone?

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

Can employers contribute to Medicare premiums?

Medicare Premiums and Employer Contributions. Per CMS, it’s illegal for employers to contribute to Medica re premiums. The exception is employers who set up a 105 Reimbursement Plan for all employees. The reimbursement plan deducts money from the employees’ salaries to buy individual insurance policies.

Is Part B premium free?

Since Part B is not premium-free like Part A is for most, you may wish to delay enrollment if you have group insurance. As stated above, the size of your employer determines whether your coverage will be considered creditable once you retire and are ready to enroll. Group coverage for employers with 20 or more employees is deemed creditable ...

Is Medicare billed first or second?

If your employer has fewer than 20 employees, then Medicare becomes primary. This means Medicare is billed first, and your employer plan will be billed second. If you have small group insurance, it’s HIGHLY recommended that you enroll in both Parts A and B as soon as you’re eligible. If you don’t, your employer’s group plan can refuse ...

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