Medicare Blog

must you go on medicare rather than stay on your employer's insurance when you turn 65

by Pink Breitenberg PhD Published 2 years ago Updated 1 year ago

If you have health insurance through a company with fewer than 20 employees, you should sign up for Medicare at 65 regardless of whether you stay on the employer plan. If you do choose to remain on it, Medicare is your primary insurance.

If you have health insurance through a company with fewer than 20 employees, you should sign up for Medicare at 65 regardless of whether you stay on the employer plan. If you do choose to remain on it, Medicare is your primary insurance.Jul 22, 2021

Full Answer

Should you stay on your company’s health insurance plan when you turn 65?

If you’re turning 65 and you’ll continue working, you face an important decision: should you stay on your company’s group health insurance plan or enroll in Medicare and a Medicare supplemental or Medicare Advantage plan? The question isn’t so simple. Your answer depends on: Who is paying for your health insurance (you and/or your employer).

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.

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).

Do I have to switch to Medicare when I turn 65?

when you turn 65, you can continue contributing to your HSA. Medicare will not force you to sign up at 65, and you'll get a special enrollment period to sign up later as long as you have a group health plan and work for an employer with 20 or more people.

Does Medicare automatically enroll you when you 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.)

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.

Do you have to keep enrolling in Medicare?

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.

What do I need to do before I turn 65?

Turning 65 Soon? Here's a Quick Retirement ChecklistPrepare for Medicare. ... Consider Additional Health Insurance. ... Review Your Social Security Benefits Plan. ... Plan Ahead for Long-Term Care Costs. ... Review Your Retirement Accounts and Investments. ... Update Your Estate Planning Documents.

Do they automatically send you a Medicare card?

You should automatically receive your Medicare card three months before your 65th birthday. You will automatically be enrolled in Medicare after 24 months and should receive your Medicare card in the 25th month.

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.

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.

Can you decline Medicare coverage?

Declining Medicare completely is possible, but you will have to withdraw from your Social Security benefits and pay back any Social Security payments you have already received.

What is the main problem with Medicare Part D?

The real problem with Medicare Part D plans is that they weren't set up with the intent of benefiting seniors. They were set up to benefit: –Pharmacies, by having copays for generic medications that are often far more than the actual cost of most of the medications.

Does my Medicare automatically renew?

Although there are a few exceptions, Medicare plans generally renew each year automatically. This is true for original Medicare as well as Medicare Advantage, Medigap, and Medicare Part D plans.

Do I need Medicare Part D if I don't take any drugs?

No. Medicare Part D Drug Plans are not required coverage. Whether you take drugs or not, you do not need Medicare Part D.

How do I know if I am automatically enrolled in Medicare?

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.

What are the enrollment periods for Medicare?

Initial Enrollment Period Now you can enroll in a Medicare plan. You have a seven-month window to join during this period — from three months before the month you turn 65, through your birthday month and to three months after the month you turn 65.

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...

How long does it take to get Medicare card?

You can get your own Medicare card online or apply for one using a form. You can also get a new card with other people. We'll send your card to the address you've given us. It'll arrive in about 3 to 4 weeks.

Who pays for health insurance?

With that in mind, it’s important to note exactly “who” is paying for your health insurance – your employer or you, the employee, or both the employer and you share the cost. When it comes to paying for health insurance people generally fall into three separate categories:

What are the different types of health insurance?

When it comes to paying for health insurance people generally fall into three separate categories: 1 Employees whose employer pays most or all of the cost of their group health plan. 2 Employees with dependents enrolled on the company plan and the employee pays part of their cost. 3 Business owners who pay 100 percent of the cost of their medical insurance.

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.

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 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.

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 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.

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 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).

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.

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

If you don’t sign up when eligible and you don’t meet an exception, you face late-enrollment penalties. Having qualifying insurance — i.e., a group plan through a large employer — is one of those exceptions. Many people sign up for Part A even if they stay on their employer’s plan.

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.

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