Medicare Blog

do i have to take medicare only from my company when i reach 65

by Aditya Klocko Published 2 years ago Updated 1 year ago
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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.

It depends on how you get your health insurance now and the number of employees that are in the company where you (or your spouse) work. 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.

Full Answer

How to enroll in Medicare if you are turning 65?

  • You have no other health insurance
  • You have health insurance that you bought yourself (not provided by an employer)
  • You have retiree benefits from a former employer (your own or your spouse’s)
  • You have COBRA coverage that extends the insurance you or your spouse received from an employer while working

More items...

Is it mandatory to sign up for Medicare?

While signing up for Medicare isn’t technically required, there are serious financial penalties and consequences for delaying or forfeiting coverage. Most people sign up for Medicare or are automatically enrolled in the program around their 65th birthday.

What age can you take Medicare?

You typically must be at least 65 years old to receive Medicare, even if you are receiving Social Security retirement benefits. There are some exceptions to this rule, however. Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.

What is the age for Medicare eligibility?

The standard age for Medicare eligibility has been 65 for the entirety of the health insurance program, which debuted in 1965. These days, fewer people are automatically enrolled in Medicare at age 65 because they draw Social Security benefits after 65. If you do not receive Social Security benefits, you will not auto-enroll in Medicare.

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Can you have Medicare and employer insurance at the same time?

Yes, you can have both Medicare and employer-provided health insurance. In most cases, you will become eligible for Medicare coverage when you turn 65, even if you are still working and enrolled in your employer's health plan.

Is Medicare optional at 65?

At age 65, or if you have certain disabilities, you become eligible for health coverage through various parts of the Medicare program. While Medicare isn't necessarily mandatory, it is automatically offered in some situations and may take some effort to opt out of.

Can you defer Medicare if you are still working?

As long as you have group health insurance from an employer for which you or your spouse actively works after you turn 65, you can delay enrolling in Medicare until the employment ends or the coverage stops (whichever happens first), without incurring any late penalties if you enroll later.

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

If you were eligible for Part A for 2 years but didn't sign up, you'll have to pay the higher premium for 4 years. Usually, you don't have to pay a penalty if you meet certain conditions that allow you to sign up for Part A during a special enrollment period.

Can I opt out of Medicare tax?

The problem is that you can't opt out of Medicare Part A and continue to receive Social Security retirement benefits. In fact, if you are already receiving Social Security retirement benefits, you'll have to pay back all the benefits you've received so far in order to opt out of Medicare Part A coverage.

What happens if I don't want Medicare Part B?

If you didn't get Part B when you're first eligible, your monthly premium may go up 10% for each 12-month period you could've had Part B, but didn't sign up. In most cases, you'll have to pay this penalty each time you pay your premiums, for as long as you have Part B.

How long before you turn 65 do you apply for Medicare?

3 monthsYour first chance to sign up (Initial Enrollment Period) It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the 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.

Is it necessary to have supplemental insurance with Medicare?

For many low-income Medicare beneficiaries, there's no need for private supplemental coverage. Only 19% of Original Medicare beneficiaries have no supplemental coverage. Supplemental coverage can help prevent major expenses.

Do you have to enroll in Medicare Part B every year?

Do You Need to Renew Medicare Part B every year? As long as you pay the Medicare Part B medical insurance premiums, you'll continue to have the coverage. The premium is subtracted monthly from most people's Social Security payments. If you don't get Social Security, you'll get a bill.

Can I delay Medicare Part A?

However, if you have to pay a premium for Part A, you can delay Part A until you (or your spouse) stop working or lose that employer coverage. You will NOT pay a penalty for delaying Part A, as long as you enroll within 8 months of losing your coverage or stopping work (whichever happens first).

Can you have Medicare Part A only?

Eligible people can choose to join Medicare Part A only, but it covers only hospital stay expenses. Delayed enrollment in Part A can mean a 10% increase to your premium when you do sign up. If you sign up for Part A only, a similar penalty applies to delayed enrollment in Part B.

When do you get Medicare if you leave your job?

In that case, you’ll get an eight-month special enrollment period to sign up for Medicare if and when you leave your job or your employer stops offering coverage. It will start the month after you separate from your employer, or the month after your group health coverage ends – whichever happens sooner.

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 ...

Do you have to double up on Medicare?

No need to double up on coverage. Many seniors are no longer employed at age 65, and thus rush to sign up for Medicare as soon as they’re able. But if you’re still working at 65, and you have coverage under a group health plan through an employer with 20 employees or more, then you don’t have to enroll in Medicare right now.

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.

How many employees do you need to be to receive Medicare?

The law requires a large employer — one with at least 20 employees — to offer you (and your spouse) the same benefits that it offers to younger employees (and their spouses). It is entirely your choice (not the employer’s) whether to: accept the employer health plan and delay Medicare enrollment.

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

Therefore, if you fail to sign up for Medicare when required, you will essentially be left with no coverage. It’s therefore extremely important to ask the employer whether you are required to sign up for Medicare when you turn 65 or receive Medicare on the basis of disability.

How long can you delay Medicare?

As long as you have group health insurance from an employer for which you or your spouse actively works after you turn 65, you can delay enrolling in Medicare until the employment ends or the coverage stops (whichever happens first), without incurring any late penalties if you enroll later. When the employer-tied coverage ends, you’re entitled to a special enrollment period of up to eight months to sign up for Medicare.

Is Medicare Part B primary or group?

If you enroll in both the group plan and Medicare Part B, be aware of the consequences. In this situation, the employer plan is always primary, meaning that it settles medical bills first and Medicare only pays for services that it covers but the employer plan doesn’t.

Can you delay Medicare enrollment?

You can’t delay Medicare enrollment without penalty if your employer-sponsored coverage comes from retiree benefits or COBRA — by definition, these do not count as active employment. Nor does it count if you work beyond 65 but rely on retiree benefits from a former employer.

Can you sell a Medigap policy?

Insurance companies are prohibited from refusing to sell you a Medigap policy or charge higher premiums based on your health or preexisting medical conditions, if you buy the policy within six months of enrolling in Part B. Outside of that six-month window, except in very limited circumstances, they can do both.

What age do you have to be to get Medicare?

You'll need to know what your coverage options will be at age 65 and adjust your Medicare enrollment to meet your needs. One other situation that can cause confusion occurs if you leave your job with a "retiree" health care plan or coverage under COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1985).

How long can you enroll in Medicare if you don't have insurance?

If you don't enroll during your IEP because you have employer group health insurance coverage, you can enroll at any time you still have employer group coverage or within 8 months after the month your employment or group coverage ends. You'll need to know what your coverage options will be at age 65 and adjust your Medicare enrollment ...

When do you have to enroll in Medicare?

If you work for an employer with fewer than 20 employees, you need to enroll in Medicare at age 65, during your IEP. Medicare becomes the primary payer and your employer's insurance becomes secondary.

When does Medicare become the primary payer?

Medicare becomes the primary payer for your health care expenses once you reach age 65 and lose your employer group coverage (assuming you work for an employer with more than 20 employees). If you continue to work, your employer's insurance pays first.

What are the pitfalls of working past 65?

5 pitfalls to avoid when working past age 65. 1. Not doing your homework: If you plan to work past age 65, or if your spouse or partner continues to work and covers you, you've got some research to do to make sure you know your options, the costs, and any restrictions. Your employer is required to offer you coverage, but is that your best option? ...

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.

How long do you have to work to get Medicare Part A?

If by the time you reach 65 you’ve worked a total of approximately 10 years over your career, you’re entitled to premium-free Medicare Part A, which pays for in-patient hospital charges and more.

How many employees do you have to have to have Medicare Part B?

If the employer has fewer than 20 employees: If your or your spouse's employer has fewer than 20 employees and the health coverage is not part of a multiemployer group plan, at age 65 you must enroll in Medicare Part B, which will be your primary insurance. If you have an HSA and want to keep contributing: If you have an HSA ...

What is Medicare Part A?

If the employer has fewer than 20 employees: If your or your spouse's employer has fewer than 20 employees and the health coverage is not part of a multiemployer group plan, at age 65 you must enroll in Medicare Part A, which will be your primary insurance. “Primary” means that Medicare pays first, and then the employer insurance kicks in ...

What happens if you overlook Medicare enrollment rules?

Medicare processes and rules are complex and rife with exceptions; if you overlook something in the enrollment rules, you may pay a high price in terms of both penalties and gaps in coverage. So you should consult with Medicare and with the benefits administrator for your employer coverage — before you enroll or decide to delay enrollment.

How long do you have to keep HSA contributions?

Stop making contributions to your HSA at least six months before you sign up for Part B. And you’ll want to sign up for Medicare at least a month before you stop work ...

Does Medicare Part A cover my employer?

Because in some cases, Medicare Part A may cover what your employer plan does not. But as with so many aspects of Medicare, there are caveats, exceptions and potential pitfalls. If the employer has 20 or more employees: If your or your spouse's employer has 20 or more employees and a group health plan, you don't have to sign up for Medicare ...

Is Medicare cheaper than group health insurance?

If your employer (or your spouse’s employer) requires you to pay a large portion of the premium on your group health insurance, you may find Medicare cheaper and the coverage adequate. So compare your current coverage and out-of-pocket expenses — including premiums, deductibles, copays and coinsurance — with your costs and benefits under Medicare, which may also pay some expenses not covered by your group plan.

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.

Does Part C include prescription drugs?

About 43% of individuals choose to get their Parts A and B benefits delivered through an Advantage Plan (Part C), which typically also includes prescription drugs (Part D) and may or may not have a premium.

Can I delay Medicare if I lose my group insurance?

The general rule for workers at companies with at least 20 employees is that you can delay signing up for Medicare until you lose your group insurance (i.e., you retire). Many people with large group health insurance delay Part B but sign up for Part A because it’s free. “It doesn’t hurt you to have it,” Roberts said.

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.

Can a 65 year old spouse get Medicare?

Some 65-year-olds with younger spouses also might want to keep their group plan. Unlike your company’s option, spouses must qualify on their own for Medicare — either by reaching age 65 or having a disability if younger than that — regardless of your own eligibility.

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.

When do you have to get Medicare?

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. This distinction is important because it can affect the package of Medicare plans you may need, especially whether you need a Medigap supplement plan.

How many employees can be covered by Medicare?

Medicare has different rules for employer health insurance plans depending on whether the plans cover more or fewer than 20 employers. We’ll call them “large” and “small” plans here. Even workplaces with fewer than 20 insured employees may qualify as large plans if they’re linked up with a multi-employer group plan.

What is a prohibition on Medicare?

This prohibition precludes the offering of benefits to Medicare beneficiaries that are alternatives to the employer’s primary plan (e.g., prescription drugs) unless the beneficiary has primary coverage other than Medicare. An example would be primary plan coverage through his/her own or a spouse’s employer.

What is the age limit for group health insurance?

If you’re 65 or older, have group health plan coverage based on your or your spouse’s current employment, and the employer has 20 or more employees, your group health plan pays first. If you’re 65 or older, have group health plan coverage based on your or your spouse’s current employment, and the employer has fewer than 20 employees, ...

Do you have to get Medicare at 65?

If an employer with a large health plan tells you that you must get Medicare at age 65, it is breaking the law. The single exception is for people turning 65 who have end-stage renal disease; they can be required to get Medicare. Employees with access to large employer-sponsored plans do not have to get Medicare, but they may do so if they wish.

Can you drop your employer's Medicare plan?

It is illegal for some employers to offer you any inducement to get Medicare and drop the employer’s plan. The story with small health plans is not so clear. In some cases, providing employees with financial help for their Medicare expenses is just fine.

Can an employer provide financial assistance for Medicare?

In the case of large employer plans, the answer is an unequivocal “no.”. Here’s the language from Medicare’s official rules.

How long do you have to sign up for Medicare?

At that point, you’re entitled to a special enrollment period of up to eight months to sign up for Medicare without risking late penalties. If the employer has 20 or more employees, the law stipulates that those 65 and older (and their spouses) must be offered exactly the same health benefits that are offered to younger employees ...

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

Therefore, if you are required to sign up for Medicare but don’t, you’ll essentially be left with little or no health coverage.

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.

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