Most of us expect that we will enroll in Medicare when we turn 65. After all, that’s what we’ve always been told as we pay our Medicare taxes from each paycheck. But more and more American adults are finding that they aren’t ready to retire at 65, and are still employed with a company that offers group health benefits. If you already have a healthcare plan, do you still need to enroll in Medicare? What if my spouse is still working and I’m covered under their plan? And if I don’t enroll in Medicare at 65, won’t I pay a penalty later?

It might surprise you to learn that, for the most part, the rules come down to the size of the employer.

If the employer has 20 or more employees… You can choose to delay your Medicare enrollment until your employer-provided coverage ends, and you won’t owe a penalty to Medicare when enrolling later. Take note that this rule applies to healthcare benefits based upon active employment only, and does not apply to those enrolled in retiree health benefits or COBRA.

On the other hand, you can choose to enroll in Medicare if you wish. You can do this while dropping your employer coverage entirely, or enroll in both plans. If you enroll in both plans, your group health benefits will pay out first, and Medicare will serve as a supplementary plan.

One drawback to enrolling in both your employer-provided plan and Medicare is that you might not be able to enroll in a Medigap plan later. Medigap providers cannot deny you coverage during your first six months of Medicare eligibility, but later on they are usually under no obligation to offer you coverage. However, when those with duel coverage lose their employer coverage, MediGap will allow you to enroll in a plan if you do so within 60 days.

If the employer has fewer than 20 employees… They get to decide whether to continue covering you under their group healthcare plan. If they require you to sign up for Medicare, it will become your primary plan and your group benefits will become secondary. With this option, you don’t lose the ability to enroll in Medigap later, as long as you do so within 63 days of your employment ending.

If you have further questions about Medicare coverage, give us a call. We can help you sort through your options and decide which route to take, based on your healthcare needs and financial priorities.