Medicare Blog

how do i get a medicare part b if i am 69 and have been on a group at work

by Shanon Willms Published 2 years ago Updated 1 year ago
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When you leave your group health coverage, the insurance carrier will mail you a creditable coverage letter to provide proof of coverage to Medicare. Additionally, if you retire and enroll in Medicare and then return to work, you can pause your Medicare Part B benefits and reenroll in the group coverage.

Full Answer

Do I have to get Medicare Part B when I turn 65?

You may be required to get Medicare Part B even when you’re still working. There are two situations in which you must get Part B when you turn 65. If your employer has fewer than 20 employees. If you’re covered by a spouse’s employer, and the employer requires covered dependents to enroll in Medicare when they turn 65.

Can my employer make me sign up for Medicare Part B?

But, there are some exceptions: If the company or organization you or your spouse work for has fewer than 20 employees, the employer may require you to sign up for Part B when you turn 65. If so, Medicare would become your primary coverage (meaning it pays bills first) and the employer coverage would be secondary.

Do I have to take Medicare Parts A and B?

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. If you don’t enroll, your employer plan may pay less – or nothing at all – for your care when it finds out. Today's Medicare Poll

What happens to my Medicare Part B when I retire?

When you eventually retire, or leave work, you'll be entitled to a special enrollment period of eight months to sign up for Part B without incurring a late penalty. AARP Membership: Join or Renew for Just $16 a Year This also applies to most people who are covered beyond age 65 by insurance from the employer of their working spouse.

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Can I enroll in Medicare Part B if I am still working?

You may be required to get Medicare Part B even when you're still working. There are two situations in which you must get Part B when you turn 65. If your employer has fewer than 20 employees. If you're covered by a spouse's employer, and the employer requires covered dependents to enroll in Medicare when they turn 65.

Do you automatically get Medicare Part B?

Medicare will enroll you in Part B automatically. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you're not getting disability benefits and Medicare when you turn 65, you'll need to call or visit your local Social Security office, or call Social Security at 1-800-772-1213.

How do I add Medicare Part B?

Contact Social Security to sign up for Part B:Fill out Form CMS-40B (Application for Enrollment in Medicare Part B). ... Call 1-800-772-1213. ... Contact your local Social Security office.If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

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

Can I have Medicare and employer coverage 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.

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.

Who is eligible for Medicare Part B?

Be age 65 or older; Be a U.S. resident; AND. Be either a U.S. citizen, OR. Be an alien who has been lawfully admitted for permanent residence and has been residing in the United States for 5 continuous years prior to the month of filing an application for Medicare.

How long does it take for Medicare Part B to be approved?

You can also call the Social Security Administration at 1-800-772-1213 or go to your local Social Security office. It takes about 45 to 90 days to receive your acceptance letter after submitting your Medicare application.

How do I add Part B to my Medicare online?

You can use one of the following options to submit your enrollment request under the Special Enrollment Period: Go to “Apply Online for Medicare Part B During a Special Enrollment Period” and complete CMS-40B and CMS-L564. Then upload your evidence of Group Health Plan or Large Group Health Plan.

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

In general, once you're enrolled in Medicare, you don't need to take action to renew your coverage every year. This is true whether you are in Original Medicare, a Medicare Advantage plan, or a Medicare prescription drug plan.

Why do doctors not like Medicare Advantage plans?

If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.

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.

Why does your zip code affect your Medicare?

Because Medicare Advantage networks of care are dependent upon the private insurer supplying each individual plan, the availability of Medicare Advantage Plans will vary according to region. This is where your zip code matters in terms of Medicare eligibility.

When will Social Security enroll you in Part A and Part B?

If you are, Social Security will automatically enroll you in Part A and Part B just before your 65th birthday. The letter sent to you with your Medicare card explains your right to opt out of Part B if you have employer insurance. To opt out, follow the instructions included in that letter within the specified deadline.

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

When you eventually retire, or leave work, you'll be entitled to a special enrollment period of eight months to sign up for Part B without incurring a late penalty. This also applies to most people who are covered beyond age 65 by insurance from the employer of their working spouse. It also applies to same-sex married couples, ...

When do you have to enroll in Part D?

Your employer plan can tell you whether it's creditable or not. If it's not, you would need to enroll in Part D during your initial enrollment period at age 65 to avoid late penalties if and when you eventually signed up.

Can you delay Part B enrollment?

It's confusing, but different rules apply to Part B and Part D in either of these situations: Part B: You can delay Part B enrollment without penalty only while you or your spouse is still actively working for the employer that provides your health insurance.

Is Medicare primary or secondary?

If so, Medicare would become your primary coverage (meaning it pays bills first) and the employer coverage would be secondary. In this case, you need to find out exactly how the employer plan will work with Medicare. If you are in an unmarried domestic partnership (same sex or opposite sex) and receive health insurance under your partner’s employer ...

Can I draw on my health savings account?

You can draw on funds already in your account, but you cannot add to them. For details, see "Can I Have a Health Savings Account as Well as Medicare?". You'll be able to sign up for Part A without risking a late penalty during the same special enrollment period when you enroll in Part B, after you finally stop working.

Do you have to take Medicare at age 65?

By law, people who continue to work beyond age 65 still must be offered the same health insurance benefits (for themselves and their dependents) as younger people working for the same employer. So your employer cannot require you to take Medicare when you turn 65 or offer you a different kind of insurance — for example, ...

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 does Medicare work with my job-based health insurance?

Most people qualify to get Part A without paying a monthly premium. If you qualify, you can sign up for Part A coverage starting 3 months before you turn 65 and any time after you turn 65 — Part A coverage starts up to 6 months back from when you sign up or apply to get benefits from Social Security (or the Railroad Retirement Board).

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.

When do you have to enroll in Medicare Part B?

When You Must Enroll in Medicare Part B. You may be required to get Medicare Part B even when you’re still working. There are two situations in which you must get Part B when you turn 65. If your employer has fewer than 20 employees. If you’re covered by a spouse’s employer, and the employer requires covered dependents to enroll in Medicare ...

How much does Medicare Part B cost?

Part B is different. Unlike Part A, Medicare Part B has a monthly premium, which can cost $148.50 to $504.90 depending on income. It has a late enrollment penalty for anybody who enrolls without qualifying for a Special Enrollment Period.

What is Medicare Made Clear?

Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.

How long does it take to enroll in Medicare if you lose your employer?

When you lose your employer coverage, you will get an 8-month Special Enrollment Period during which to enroll in Medicare Part B, and Part A if you haven’t done so already. You’ll also be able to enroll in a Medicare Advantage (Part C) plan or Part D prescription drug plan in the first two months of this period.

When do dependents have to enroll in Medicare?

If you’re covered by a spouse’s employer, and the employer requires covered dependents to enroll in Medicare when they turn 65. If you’re not married but living in a domestic partnership and are covered by your partner’s employer health insurance.

Can you avoid Medicare if you file for Social Security?

PHIL: When you file for Social Security, by law you must receive Part A of Medicare. You can't avoid it. If you want to get Social Security benefits, you have to be enrolled in Part A.

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.

What is the primary payer for Medicare?

If the company you work for has 2 to 19 employees, then Medicare is the primary payer, which means that Medicare pays your medical claims first, and then your company’s health insurance plan pays its portion.

Do you have to be enrolled in Medicare if you are 65?

Many of the insurance companies assume that a 65-year-old member of the group health plan is enrolled in Medicare Parts A and B, and they pay claims as if the member were enrolled. Either you must enroll in Parts A and B to stay on the group health plan, or the premium is significantly higher if you are not enrolled.

Can my employer pay for my Medicare?

Important: Know that your employer can not induce you to enroll in Medicare (i.e., your employer can’t pay for your Medicare and Med Sup plan – nor can your employer pay you a bonus to enroll in Medicare.) If you chose to enroll in a Med Sup plan, you’ll have to pay the entire premium for Medicare and the Med Sup yourself.

Does California charge higher premiums for Medicare?

Some health insurance companies in California simply charge much higher premiums for enrollees age 65 and over without regard for enrollment in Medicare Part B. Learn about how to enroll in Medicare and a Med Sup plan.

Is Medicare the primary or secondary payer?

If the company you work for has 2 to 19 employees, then Medicare is the primary payer, which means that Medicare pays your medical claims first, and then your company’s health insurance plan pays its portion. If your employer has 20 or more employees, then Medicare is the secondary payer, and your group health plan pays your claims first.

Do you have to pay for Med Sup?

If you chose to enroll in a Med Sup plan, you’ll have to pay the entire premium for Medicare and the Med Sup yourself. The U.S. Department of Labor actually audits employers to see if they are violating this law.

When do you have to take Part B?

You have to take Part B once your or your spouse’s employment ends. Medicare becomes your primary insurer once you stop working, even if you’re still covered by the employer-based plan or COBRA. If you don’t enroll in Part B, your insurer will “claw back” the amount it paid for your care when it finds out.

What is a Part B SEP?

The Part B SEP allows beneficiaries to delay enrollment if they have health coverage through their own or a spouse’s current employer. SEP eligibility depends on three factors. Beneficiaries must submit two forms to get approval for the SEP. Coverage an employer helps you buy on your own won’t qualify you for this SEP.

What is a SEP for Medicare?

What is the Medicare Part B Special Enrollment Period (SEP)? The Medicare Part B SEP allows you to delay taking Part B if you have coverage through your own or a spouse’s current job. You usually have 8 months from when employment ends to enroll in Part B. Coverage that isn’t through a current job – such as COBRA benefits, ...

How long can you delay Part B?

You can delay your Part B effective date up to three months if you enroll while you still have employer-sponsored coverage or within one month after that coverage ends. Otherwise, your Part B coverage will begin the month after you enroll.

What to do if your Social Security enrollment is denied?

If your enrollment request is denied, you’ll have the chance to appeal.

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.

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 ...

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.

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 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.

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