Medicare Blog

if i dont get medicare at 65 what proof do i need to show i have employer ins

by Cecelia Zieme Published 3 years ago Updated 2 years ago
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You will need your employer to fill out the CMS-L564 form. This form is a request for employment information and will provide proof of creditable coverage to Medicare. Once the employer completes Section B of the form, send in the document with your application to enroll in Medicare.

Full Answer

Do you have to work past 65 to qualify for Medicare?

Nor does it count if you work beyond 65 but rely on retiree benefits from a former employer. You (or your spouse) must be actively working for the employer that currently provides your health insurance in order to delay Medicare enrollment and qualify for a special enrollment period later on.

What happens if I don’t sign up for Medicare when I’m 65?

What happens if I don’t sign up for Medicare when I’m 65? A. Joining Medicare is voluntary. But there may be consequences—in the form of a late penalty—if you don’t enroll at the “right” time, depending on your circumstances.

Do I need my employer to fill out a Medicare form?

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. Can an employer force an employee to enroll in Medicare?

Do I have to tell Medicare about my work plans?

You don’t have to tell Medicare about your work plans. If you don’t want to sign up for Part A (or B) when you turn 65, you can continue contributing to your HSA.

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How can I prove I don't have Medicare?

To show lack of Medicare eligibility or enrollment:Letter or statement from Medicare or the Social Security Administration stating that you or your family members are: ... If you are unable to obtain this letter, you may complete and submit an Attestation of Medicare Eligibility and Enrollment Status form.

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 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.

What do I do if I don't have Medicare Part B?

If you don't want Part B, follow the instructions received with your red, white and blue Medicare card. If you keep the card, you keep Part B and must pay Part B premiums. If you won't be receiving Social Security or RRB benefits at least four months before turning 65, you don't need to do anything.

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.

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.

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...

Do I automatically get Medicare when I 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.)

Can my employer pay for my Medicare premiums?

Can my employer pay my Medicare premiums? Employers can't pay employees' Medicare premiums directly. However, they can designate funds for workers to apply for health insurance coverage and premium payments with a Section 105 plan.

Can you add Medicare Part B at any time?

You can sign up for Medicare Part B at any time that you have coverage through current or active employment. Or you can sign up for Medicare during the eight-month Special Enrollment Period that starts when your employer or union group coverage ends or you stop working (whichever happens first).

Can you collect Social Security without Medicare?

Yes, many people receive Social Security without signing up for Medicare. Most people aren't eligible for Medicare until they turn 65. As you can start collecting Social Security retirement benefits at 62, individuals may have Social Security without Medicare for several years.

Can a person opt out of 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 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.

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.

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 ...

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.

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 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.

What happens if you don't get Social Security at 65?

If you’re still working at age 65 and you’re not claiming Social Security benefits, the government will not automatically enroll you in Medicare Part A, which covers hospital stays. 1 

Who is eHealth Medicare?

If you qualify for Medicare and are ready to look at plans, eHealth Medicare, an independent insurance broker and partner of Investopedia, has licensed insurance agents at <833-970-1257 TTY 711>; who can help connect you with Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Part D plans.

How long do you have to enroll in Part B?

If it doesn’t, you should enroll in Part B to avoid paying the premium penalty that’s imposed if you don’t enroll in Part B within eight months of becoming eligible for it. 1 .

What is the phone number for Medicare?

If you have an urgent matter or need enrollment assistance, call us at 800-930-7956. By submitting your question here, you agree that a licensed sales representative may respond to you about Medicare Advantage, Prescription Drug, and Medicare Supplement Insurance plans.

How long do you have to enroll in Part B?

There are two main times when you can enroll in part B when you are over 65 and covered by your employer’s insurance: 1 While your work coverage is still active 2 During the eight month period after your employer-based coverage ends or the employment ends, whichever occurs first.

Can seniors over 65 delay Medicare?

Senior65 generally recommends those over 65 delay enrolling in Medicare Part B if they are offered coverage through work (including spouse’s work). We all want to stay clear of paying Medicare late-enrollment penalties while avoiding gaps in coverage. This is where Senior65 comes in to make sense of it all.

Does Medicare Part B start at the same time?

That way you can time it that when your work coverage ends, your Medicare Part B (and any supplemental or drug coverage you may purchase) all start at the same time. You should not have a gap when your work coverage has ended but your Medicare has yet to begin.

How long does Medicare coverage last?

This special period lasts for eight months after the first month you go without your employer’s health insurance. Many people avoid having a coverage gap by signing up for Medicare the month before your employer’s health insurance coverage ends.

Does Medicare cover health insurance?

Medicare covers any remaining costs. Depending on your employer’s size, Medicare will work with your employer’s health insurance coverage in different ways. If your company has 20 employees or less and you’re over 65, Medicare will pay primary. Since your employer has less than 20 employees, Medicare calls this employer health insurance coverage ...

Does Medicare pay second to employer?

Your health insurance through your employer will pay second and cover either some or all of the costs left over. If Medicare pays secondary to your insurance through your employer, your employer’s insurance pays first. Medicare covers any remaining costs. Depending on your employer’s size, Medicare will work with your employer’s health insurance ...

Can an employer refuse to pay Medicare?

The first problem is that your employer can legally refuse to make any health-related medical payments until Medicare pays first. If you delay coverage and your employer’s health insurance pays primary when it was supposed to be secondary and pick up any leftover costs, it could recoup payments.

What happens if you leave Medicare without a creditable coverage letter?

Without creditable coverage during the time you’ve been Medicare-eligible, you’ll incur late enrollment penalties. When you leave your group health coverage, the insurance carrier will mail you a creditable coverage letter. You’ll need to show this letter to Medicare to protect yourself from late penalties.

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.

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 ...

Is a $4,000 hospital deductible a creditable plan?

For your outpatient and medication insurance, a plan from an employer with over 20 employees is creditable coverage. This safeguards you from having to pay late enrollment penalties for Part B and Part D, ...

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 ...

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.

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