Medicare Blog

do you have to take medicare when you're 65 or could you still stay with obamacare

by Fabiola Walsh Published 2 years ago Updated 1 year ago
image

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.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.Jul 31, 2015

Full Answer

Do you have to sign up for Medicare when you turn 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. Temporary coverage available in certain situations if you lose job-based coverage.

Can a 65 year old delay Medicare enrollment?

Your Medicare special enrollment period If your employer has at least 20 employees and you’re still working and covered under that plan when you turn 65, you can delay your enrollment in Medicare (specifically in Medicare Part B, which allows you to avoid the Part B premium while you’re covered under your employer’s plan).

How does Obamacare work if you are over 65 but not Medicare?

Here is How ObamaCare Works if You are Over 65, But Don't Qualify For Medicare You’re over 65 but not eligible for Medicare. You are eligible to get coverage on HealthCare.gov (the ObamaCare marketplace). If you meet the qualifications based on income and family size, you are eligible for cost-saving subsidies, too.

Do I have to enroll in Medicare if I'm still working?

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. But if your employer has less than 20 employees, you need to take Medicare Parts A and B, because that will be your primary insurance.

image

Do you lose Obamacare when you turn 65?

Yes, in general, people age 65 or older who are not entitled to premium-free Medicare can purchase health insurance coverage in the Marketplace (except undocumented immigrants).

Can you have Obamacare and Medicare at the same time?

Can I get a Marketplace plan in addition to Medicare? No. It's against the law for someone who knows that you have Medicare to sell you a Marketplace plan. This is true even if you have only Part A (Hospital Insurance) or only Part B (Medical Insurance).

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

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. For example, suppose that: You were eligible for Medicare in 2020, but you didn't sign up until 2022.

How long can you stay on Obamacare?

You can stay on a parent's plan until you turn 26 Once you're on a parent's job-based plan, in most cases you can stay on it until you turn 26. Generally, you can join a parent's plan and stay on until you turn 26 even if you: Get married.

Is Obamacare good for seniors?

Free Preventive Services and Annual Wellness Visit These include flu shots, mammograms, and tobacco use cessation counseling, as well as no-cost screenings for cancer, diabetes, and other chronic diseases. Seniors can also get a free annual wellness visit, so they can talk to their doctor about any health concerns.

Does Medicare automatically start at 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 I don't enroll in Medicare?

If you don't enroll when you're first eligible for Medicare, you can be subject to a late-enrollment penalty, which is added to the Medicare Part A premium. The penalty is 10% of your monthly premium, and it applies regardless of the length of the delay.

Is there a penalty for not enrolling in Medicare?

Currently, the late enrollment penalty is calculated by multiplying 1% of the “national base beneficiary premium” ($33.37 in 2022) by the number of full, uncovered months that you were eligible but didn't enroll in Medicare drug coverage and went without other creditable prescription drug coverage.

Do I have to get Part B Medicare?

Medicare Part B isn't a legal requirement, and you don't need it in some situations. In general, if you're eligible for Medicare and have creditable coverage, you can postpone Part B penalty-free. Creditable coverage includes the insurance provided to you or your spouse through work.

What is the difference between Obamacare and Medicare?

What Is the Difference Between Medicare and Obamacare? Medicare is insurance provided by the federal government for people over the age of 65 and the disabled, and Obamacare is a set of laws governing people's access to health insurance.

Is Obamacare still in effect for 2021?

Yes, the Affordable Care Act (also called Obamacare) is still in effect.

Can I keep my private insurance and Medicare?

It is possible to have both private insurance and Medicare at the same time. When you have both, a process called “coordination of benefits” determines which insurance provider pays first. This provider is called the primary payer.

When do you need to sign up for Medicare?

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.

What is a Medicare leave period?

A period of time when you can join or leave a Medicare-approved plan.

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

You can get Medicare drug coverage once you sign up for either Part A or Part B. You can join a Medicare drug plan or Medicare Advantage Plan with drug coverage anytime while you have job-based health insurance, and up to 2 months after you lose that insurance.

What happens if you don't sign up for Part A and Part B?

If you don’t sign up for Part A and Part B, your job-based insurance might not cover the costs for services you get.

Do you have to tell Medicare if you have non-Medicare coverage?

Each year, your plan must tell you if your non-Medicare drug coverage is creditable coverage. Keep this information — you may need it when you’re ready to join a Medicare drug plan.

Does Medicare work if you are still working?

If you (or your spouse) are still working, Medicare works a little differently. Here are some things to know if you’re still working when you turn 65.

Do I need to sign up for Medicare when I turn 65?

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.

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.

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 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 ...

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.

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 ...

How long do you have to sign up for a Part B plan?

Sign up during those eight months, and you won’t have to worry about premium surcharges for being late. And the eight-month special enrollment period is also available if you’re delaying Part B enrollment because you’re covered under your spouse’s employer-sponsored plan, assuming their employer has at least 20 employees.

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 much does a 65 year old pay for medicare?

A 65-year-old male will pay anywhere from $126 to $464 monthly for a Medigap policy, according to the American Association for Medicare Supplement Insurance. For 65-year-old women, the range is $118 to $464.

How old do you have to be to sign up for Medicare?

While workers at businesses with fewer than 20 employees generally must sign up for Medicare at age 65 , people working for larger companies typically have a choice: They can stick with their group plan and delay signing up for Medicare without facing penalties down the road, or drop the company option and go with Medicare.

What to do if you are 65 and still working?

If you’ll hit age 65 soon and are still working, here’s what to do about Medicare 1 The share of people age 65 to 74 in the workforce is projected to reach 30.2% in 2026, up from 26.8% in 2016 and 17.5% in 1996. 2 If you work at a company with more than 20 employees, you generally have the choice of sticking with your group health insurance or dropping the company option to go with Medicare. 3 If you delay picking up Medicare, be aware of various deadlines you’ll face when you lose your coverage at work (i.e., you retire).

How long does Medicare last?

Original, or basic, Medicare consists of Part A (hospital coverage) and Part B (outpatient and medicare equipment coverage). You get a seven-month window to sign up that starts three months before your 65th birthday month and ends three months after it.

What happens if you delay picking up Medicare?

It’s becoming a common scenario: You’re creeping closer to your 65th birthday, which means you’ll be eligible for Medicare, yet you already have health insurance through work.

How many employees can you delay signing up for Medicare?

If you work at a large company. 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). At that point, you’d be subject to various deadlines to sign up or else face late-enrollment penalties.

Can you continue taking a specialty drug under Medicare?

On the other hand, if you take a specialty drug that is covered by your group plan, it might be wise to continue with it if that drug would be more expensive under Medicare. Some 65-year-olds with younger spouses also might want to keep their group plan.

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 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.

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.

How does Obamacare work?

Here is How ObamaCare Works if You are Over 65, But Don't Qualify For Medicare . You’re over 65 but not eligible for Medicare. You are eligible to get coverage on HealthCare.gov (the ObamaCare marketplace). If you meet the qualifications based on income and family size, you are eligible for cost-saving subsidies, too.

What happens if you don't enroll in tricare?

However, you losing your creditable coverage should trigger a special enrollment period for Part B (generally people would have Part B and TRICARE, but if TRICARE was considered creditable coverage for you, then it shouldn’t be the case).

What is the poverty level for Medicaid?

ps. In some states you may have Medicaid options if your income is below 138% of the poverty level.

Do you have to have Medicare if you are over 65?

You don’t have any health coverage. If you are over 65 the fee for not having coverage still applies to you. Whether you get a Marketplace plan, get Medicare, or keep a retiree plan from a previous employer you are covered.

Is Medicare.Gov a good place to start?

If you are Medicare age a great place to start your journey is Medicare .Gov, if not then Healthcare.gov is best. It isn’t that these are your only options, it is that this is a good place to start when you are confused. Enrolling in Medicare is a little complex and must be done during open enrollment periods.

Can an elder relative get medicaid?

An elder relative who is 65 years of age, permanent legal resident, he is qualified not qualified for medicare as he does not have enough work credits. He could not get the medicaid as it automatically kept putting him on medicare. What would be the best next step of actions for him?

Can my mother get Medicaid in New York?

New York has expanded Medicaid and your mother would qualify for Medicaid because she has no income. In addition, you may also be able to be included in your tax family as a qualifying relative and claimed as your dependent. This would allow you to apply for health insurance together and for you to claim an additional dependent exemption and filing as head of household (assuming you couldn’t already), which could potentially lower your tax burden.

When will Medicare be sent out to my 65 year old?

If you’re already receiving Social Security or Railroad Retirement benefits, the government will automatically enroll you in Medicare Part A the month you turn 65, with your Medicare card arriving in the mail about three months before you turn 65. If you’re not yet receiving Social Security or Railroad Retirement benefits, ...

When will Medicare be enrolled in Social Security?

Here are the details: If you’re already receiving retirement benefits from Social Security or the Railroad Retirement Board, you’ll automatically be enrolled in Medicare with an effective date of the first of the month that you turn 65. As is the case for people who enroll prior to the month they turn 65, premium subsidy eligibility ends on ...

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

And if you keep your individual market exchange plan and don’t sign up for Medicare when you first become eligible, you’ll have to pay higher Medicare Part B premiums for the rest of your life, once you do enroll in Medicare, due to the late enrollment penalty.

How long does it take to get Medicare if you are not receiving Social Security?

If you’re not yet receiving Social Security or Railroad Retirement benefits, you’ll have a seven-month window during which you can enroll in Medicare, which you’ll do through the Social Security Administration. Your Medicare card will be sent to you after you enroll. Your enrollment window starts three months before the month you turn 65, ...

When does Medicare coverage take effect?

If you complete the enrollment process during the three months prior to your 65th birthday, your Medicare coverage takes effect the first of the month you turn 65 ( unless your birthday is the first of the month ). Your premium subsidy eligibility continues through the last day of the month prior to the month you turn 65.

When does Medicare subsidy end?

The short story is that if you enroll in Medicare during the first four months of your initial enrollment window, your transition to Medicare will be seamless, with subsidy eligibility continuing through the last day of the month prior to the month that your Medicare coverage begins. If you enroll in Medicare during the final three months of your initial enrollment period, your premium subsidy will likely end before your Part B coverage begins, although your Part A coverage should be backdated to the month you turned 65. And if you don’t enroll in Medicare at all during your initial enrollment window, your premium subsidies will end a few months after you turn 65. Here are the details:

When will Medicare be sent to you?

Your Medicare card will be sent to you after you enroll. Your enrollment window starts three months before the month you turn 65, includes the month you turn 65, and then continues for another three months. (Note that you’ll need to enroll during the months prior to your birth month in order to have coverage that takes effect the month you turn 65.

image
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9