Medicare Blog

if you have health insurance when retired do you need medicare

by Brando Kautzer II Published 2 years ago Updated 1 year ago
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Even if you have a retiree health plan, you most likely need to sign up for Medicare. Depending on the plan, you may need to sign up for Part A and Part B, or just Part A (you must be eligible for Part B). Retiree health coverage might not pay some medical costs during any period in which you were eligible for Medicare but didn’t enroll.

Full Answer

Do you need health insurance when you retire?

If you retire before age 65, you'll need to find a health insurance plan to cover you until you're eligible for Medicare. Regardless of your age, you have retirement health insurance options.

Do I have to enroll in Medicare to keep my retiree insurance?

This means you need to enroll in Medicare to be fully covered. Some retiree policies require you to sign up for Parts A and B once you become Medicare-eligible. You may be able to keep your retiree insurance as primary after you become Medicare-eligible if you have:

Do you need Medicare if you retire before 65?

If you're planning on retiring before age 65, that's a good thing. When you’re age 65, you should become eligible for Medicare, but you’ll still have choices to make. For example, you may want original Medicare or a Medicare Advantage Plan.

Do you need Medicare if you already have health insurance?

The age of eligibility for Medicare is 65, but what if you already have health insurance? Most people first become eligible for Medicare Parts A and B at age 65, but that doesn't mean everybody needs it at that age. If you have employer coverage at the time you reach the age of eligibility, you may not need to apply for Medicare insurance just yet.

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How long does it take to enroll in a health plan after separation?

You can apply to the Marketplace with a Special Enrollment Period any time from 60 days before and 60 days after your separation date.

Can I get Medicare Marketplace before I start?

Yes. You can get a Marketplace plan to cover you before your Medicare begins. You can then cancel the Marketplace plan once your Medicare coverage starts. Learn more if you have Marketplace coverage but will soon be eligible for Medicare.

Can I retire at 65 without health insurance?

If you retire before age 65 without health coverage. If you retire before you’re 65 and lose your job-based health plan when you do, you can use the Health Insurance Marketplace® to buy a plan. Losing health coverage qualifies you for a Special Enrollment Period.

Can I get premium tax credits if I have retiree health insurance?

If you have retiree health benefits. If you have retiree coverage and want to buy a Marketplace plan instead, you can. But: You can’t get premium tax credits and other savings based on your income. This is true only if you’re actually enrolled in retiree coverage.

Can you drop Cobra coverage if it's not running out?

The Special Enrollment Period applies only if your COBRA coverage runs out. During the annual Open Enrollment Period, you can drop your COBRA coverage even if it’s not running out and replace it with a Marketplace plan. Learn more about switching to Marketplace coverage from COBRA.

What age do you have to be to get Medicare?

The age of eligibility for Medicare is 65, and some people are enrolled automatically while others need to sign up. If you're already receiving Social Security or Railroad Retirement Board (RRB) retirement benefits, you'll automatically be enrolled in Medicare Parts A and B on the first day of the month you turn 65.

How long does it take to sign up for Medicare?

The most convenient way to sign up for Medicare is online through the Social Security Administration's website. The application takes less than 10 minutes, there are no forms to sign, and there's usually no further documentation requirement. Try any of our Foolish newsletter services free for 30 days.

Is retirement considered employment based?

However, it's important to be aware that if you retire and are allowed to stay enrolled in your former employer's plan, it's not considered employment-based coverage (after all, you're not "employed" at that point) for the purposes of obtaining a special enrollment period.

When do you get Medicare?

Medicare is a public health insurance program that you qualify for when you turn 65 years old. This might be retirement age for some people, but others choose to continue working for many reasons, both financial and personal. In general, you pay for Medicare in taxes during your working years and the federal government picks up a share of the costs.

How long do you have to sign up for Medicare if you have an employer?

Once your (or your spouse’s) employment or insurance coverage ends, you have 8 months to sign up for Medicare if you’ve chosen to delay enrollment.

What is Medicare Supplement?

Medicare Supplement, or Medigap, plans are optional private insurance products that help pay for Medicare costs you would usually pay out of pocket . These plans are optional and there are no penalties for not signing up; however, you will get the best price on these plans if you sign up during the initial enrollment period that runs for 6 months after you turn 65 years old.

Does Medicare cover late enrollment?

Medicare programs can help cover your healthcare needs during your retirement years. None of these programs are mandatory, but opting out can have significant consequences. And even though they’re option, late enrollment can cost you.

Do you have to sign up for Medicare if you are 65?

Medicare is a federal program that helps you pay for healthcare once you reach age 65 or if you have certain health conditions. You don ’t have to sign up when you turn 65 years old if you continue working or have other coverage. Signing up late or not at all might save you money on monthly premiums but could cost more in penalties later.

Do you pay Medicare premiums when you turn 65?

Because you pay for Medicare Part A through taxes during your working years, most people don’t pay a monthly premium. You’re usually automatically enrolled in Part A when you turn 65 years old. If you’re not, it costs nothing to sign up.

Is Medicare mandatory?

While Medicare isn’t necessarily mandatory, it may take some effort to opt out of. You may be able to defer Medicare coverage, but it’s important to if you have a reason that makes you eligible for deferment or if you’ll face a penalty once you do enroll.

What to do if you retire before you qualify for Medicare?

If you're retiring before you're eligible for Medicare, compare the cost of retiree health insurance or COBRA to Marketplace insurance plans. You should also ask how the coverage changes when you're eligible for Medicare.

What age do you have to retire to get health insurance?

If you retire before age 65, you may need to find a health insurance plan to cover you until you're eligible for Medicare. Regardless of your age, you have retirement health insurance options. President Biden has signed an executive order for a special enrollment period for HealthCare.gov to assist those who have lost health insurance due ...

What are the options for Medicare if you don't have employer health coverage?

The two primary options if you don't have access to employer health coverage are: Medicare supplements: Also known as Medigap plans, these plans help cover the gaps in Medicare.

What are the different types of Medicare?

Medicare has the following parts: 1 Part A covers inpatient hospital care, limited care in a skilled nursing facility, hospice care, and some home health care. 2 Part B covers other aspects of health care, including outpatient care, doctor care, and durable medical equipment. You pay a monthly premium for Part B. 3 Part D covers prescriptions, and its benefits are accessed by purchasing Part D plans through private insurance companies.

What is the Medicare handbook?

Each year you're eligible for Medicare, you'll receive a handbook called "Medicare & You.". This handbook reviews how Medicare works and provides in-depth information on any changes. You can also download the handbook or opt to be sent an electronic copy each year.

What can an experienced health insurance agent do?

An experienced health insurance agent can help you navigate your retirement health insurance options. They can conduct a complete analysis of your options by asking you about your existing doctors and medications and then tell you which plans will provide the most cost-effective benefits based on your personal medical situation.

How old do you have to be to qualify for Medicare?

In most cases, as long as you've worked at least 10 years and paid Medicare taxes during those years, you're eligible for Medicare starting at age 65. If you're permanently disabled or have end-stage renal disease, you can qualify for Medicare before age 65. 7

What happens if you don't enroll in Medicare?

As a federal retiree, if you don’t enroll in Medicare, your FEHB plan will act as your primary insurer and won’t pay less because you qualify for Medicare.

How long before you can change your FEHB coverage?

You may want to make changes to your FEHB coverage when you are nearing Medicare eligibility, and will have the option to do this starting 30 days before you qualify for Medicare. Changes can only be made once during this window. You can also wait until FEHB Open Season to change your coverage. Back to top.

Can you suspend your Medicare Advantage plan?

You can suspend your enrollment in FEHB to enroll in Medicare Advantage or other eligible coverage by contacting your agency’s retirement system, and providing them documentation that you enrolled . If you do this , you’ll be allowed to leave your Medicare Advantage plan and return to FEHB.

Is FEHB covered by Medicare?

While FEHB plans cover most of the same types of expenses that Medicare covers, FEHB plans’ coverage may be more limited than Medicare Part B when it comes to orthopedic and prosthetic devices , durable medical equipment, home healthcare, medical supplies, and chiropractic care.

Can you pay Medicare excess?

Some states don’t allow excess Medicare charges. If you live in one of these states – or you see a doctor in any state that accepts Medicare’s rate as full payment – you’d only have to pay the difference between what Medicare and your FEHB plan pay and Medicare’s rate.

Is FEHB more generous than Medicare?

Although FEHB coverage can be more generous overall than Medicare Advantage or Original Medicare, having additional coverage may not be helpful if you can’t afford its premiums. If you qualify for the Medicare Savings Program (MSP) or Medicaid, you may find your healthcare costs are lower overall if you don’t use FEHB.

Signing up for Medicare might make sense even if you have private insurance

Jeffrey M. Green has over 40 years of experience in the financial industry. He has written dozens of articles on investing, stocks, ETFs, asset management, cryptocurrency, insurance, and more.

How Medicare Works

Before diving into how Medicare works with your existing health coverage, it’s helpful to understand how it works on its own. Medicare has four main parts: A, B, C, and D. You can also purchase Medicare supplement insurance, known as Medigap.

Medicare Enrollment Periods

Medicare has a few enrollment periods, but the initial enrollment period may be the most important. This is when you first become eligible for Medicare. And if you miss the deadline to sign up for Parts B and D, you could face expensive penalties .

How Medicare Works If You Have Private Insurance

If you have private insurance, you may want to sign up for Parts A, B, D—and possibly a Medicare Advantage plan (Part C) and Medigap, once you become eligible. Or not. There are reasons both for and against. Consider how the following types of coverage work with Medicare to help you decide.

Primary and Secondary Payers

Your Medicare and private insurance benefits are coordinated, which means they work together. Typically, a primary payer will pay insurance claims first (up to plan limits) and a secondary payer will only kick in for costs not covered by the primary payer.

Frequently Asked Questions (FAQs)

No, you can delay signing up for Medicare without penalty, as long as you are covered by another type of private insurance. Generally, if you are eligible for premium-free Part A, you should still sign up for it, even if you have additional private insurance coverage. 18

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.

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