What Do You Do About Medicare If You’re Still Working at Age 65?

April 19, 2024
Posted in Medicare
April 19, 2024 Jonathan Nolan

What Do You Do About Medicare If You’re Still Working at Age 65?

Reaching the age of 65 is a significant milestone, especially when it comes to healthcare options. For many, turning 65 brings up questions about Medicare, even for those who are still employed and covered under an employer’s health plan. Understanding your options and the implications can help you make the best decisions for your health care coverage.

To begin with, it’s important to know that even if you are still working, you are eligible to enroll in Medicare starting three months before the month of your 65th birthday. Enrollment can occur at any time while you are still working or during the eight months following the month when your employment or employment-based health insurance ends, whichever happens first.

Here are a few other things you should know:

Delaying Medicare Enrollment:  One viable option for those still employed is to delay Medicare Part B and Part D enrollment if you have coverage through your or your spouse’s employer. This can be a sensible choice if the employer’s plan offers favorable benefits that would be more costly to replace with Medicare. Delaying your Part B and Part D enrollment can avoid paying premiums for benefits you already receive from your employer.

However, it’s crucial to compare your current plan with Medicare’s offerings. Some employer plans might have a high deductible or limited network which could make Medicare a more attractive option despite the additional premiums.

Enrolling in Medicare Part A:  Most people should enroll in Medicare Part A (hospital insurance) when they’re first eligible, as it generally comes with no premium if you or your spouse paid Medicare taxes while working. This can be particularly beneficial because Part A coverage can work as a secondary insurance to your employer’s plan, covering hospital costs not fully covered by the primary plan.

Combining Medicare with Employer Insurance:  When you choose to combine Medicare with employer coverage, Medicare generally becomes the secondary payer. For those who decide to enroll in Medicare alongside their employer’s health plan, coordinating the benefits can ensure that they complement each other effectively. This strategy often leads to reduced out-of-pocket expenses when receiving medical care.

Please Note:  If you elect to combine coverage and your employer has more than 20 employees, then your employer’s plan will be your primary.  If they have less than 20 employees, then Medicare will be your primary.

Medicare Advantage as an Alternative:  Another factor to consider is whether a Medicare Advantage plan might be more suitable. These plans are offered by private companies approved by Medicare and may provide extra benefits such as dental, vision, and prescription drug coverage, which might not be adequately covered under your employer’s plan.

Consult with Us:  Enrolling in Medicare can be confusing for anyone, whether you are still working or not. We can provide insights into how your employer’s plan and Medicare would interact, and help you understand any consequences of choosing one over the other.  We’ll fully explain your options and answer your questions.

The Importance of Timely Decisions Making timely decisions is crucial because failing to enroll in Medicare when required can lead to penalties, higher premiums, and gaps in coverage. Particularly, if you decide to enroll in Medicare after your employer coverage ends, ensure that you do not miss the enrollment periods.

Deciding whether to enroll in Medicare while still employed at 65 involves careful consideration of your current health coverage, your health needs, and the financial implications. Balancing the benefits offered by your employer’s plan with those provided by Medicare requires a thorough comparison to ensure you have comprehensive coverage that meets your needs without unnecessary overlap or expense.


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