Do You Have To Be On Medicare At 65
When you turn 65 years old, youâre eligible to sign up for Medicare.
Original Medicare is made up of 2 main parts: Part A and Part B .
As long as youâve worked at least 10 years and paid Medicare taxes, Medicare Part A is actually free to have, meaning that you donât have a monthly premium to pay. Thereâs really no downside to having Part A when you turn 65.
Do you have to have Part A when you turn 65? No. Is there any downside to having Part A when you turn 65? No. Thatâs why you donât actually have to sign up for Part A.
Three months before you turn 65, youâll be mailed your Medicare card, and youâre automatically enrolled in Part A. Youâll also be automatically enrolled in Part B unless you send the card back explaining that you donât want it.
Which brings us to our next question â is Medicare Part B mandatory at age 65?
Our team of licensed agents can help you determine which route would save you the most money, so if youâre not sure, be assured that we can help. Call us any time at 833-801-7999.
Ask These Questions Before You Delay Medicare
Whether or not you can delay Medicare past 65 when youre working really depends on a few simple questions.
1. Do you have employer health coverage?
2. Does your employer have 20 or more employees?
3. Is the coverage considered creditable?
If you can answer Yes! to all the above, you likely qualify for a Medicare Special Enrollment Period and can delay enrolling without penalty. Whats the next step? and information sent directly to your inbox.
Already Enrolled In Medicare
If you have Medicare, you can get information and services online. Find out how to .
If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You can use one of the following options to submit your enrollment request under the Special Enrollment Period:
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Some people with limited resources and income may also be able to get .
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D Late Enrollment Penalty
The Part D late enrollment penalty is similar to the Part B late enrollment penalty, in that you have to keep paying it for as long as you have Part D coverage. But it’s calculated a little differently. For each month that you were eligible but didn’t enroll , you’ll pay an extra 1% of the national base beneficiary amount.
In 2020, the national base beneficiary amount is $32.74/month. Medicare Part D premiums vary significantly from one plan to another, but the penalty amount isn’t based on a percentage of your specific planit’s based instead on a percentage of the national base beneficiary amount. Just as with other parts of Medicare, Part D premiums change from one year to the next, and the national base beneficiary amount generally increases over time.
So a person who delayed Medicare Part D enrollment by 27 months would be paying an extra $8.84/month , on top of their Part D plan’s monthly premium in 2020. A person who had delayed their Part D enrollment by 52 months would be paying an extra $17.02/month. As time goes by, that amount could increase if the national base beneficiary amount increases . People subject to the Part D late enrollment penalty can pick from among several plans, with varying premiums. But the Part D penalty will continue to be added to their premiums for as long as they have Part D coverage.
What Are Cases When Medicare Automatically Starts
Medicare will automatically start when you turn 65 if youve received Social Security Benefits or Railroad Retirement Benefits for at least 4 months prior to your 65th birthday.
Youll automatically be enrolled in both Medicare Part A and Part B at 65 if you get benefit checks. According to the Social Security Administration, more than 30% of seniors claim Social Security benefits early.1 For those seniors, Medicare Part A and Part B will automatically start when they reach the age of 65.
When do You Get Your Medicare Card?
You can expect to receive your Medicare card in the mail three months before your birthday. Your Medicare card will come with a complete enrollment package that includes basic information about your coverage. Your card wont be usable until you turn 65, even though youll receive the card before that time.
What Are Your Costs?
Keep in mind that youll still have to pay the usual costs of Medicare, even though youre automatically enrolled. Once your Medicare is active, the cost of your Part B premium will be deducted from your Social Security or RRB benefits.
What If You Already Enrolled in Medicare?
What about Medicare Supplement ?
What If I Switch to Medicare Advantage?
What I Have Part A?
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Is It Mandatory To Sign Up For Medicare After Age 65
No, it isnt mandatory to join Medicare. People can opt to sign up, or not.
If you dont qualify for Social Security retirement benefits yet, you may need to manually enroll in Medicare at your local Social Security office, online or over the phone when you turn 65. You can also apply online for your Medicare coverage at www.medicare.gov.
Enrolling in Medicare as soon as youre eligible ensures you get the subsidized health care you deserve without waiting periods or financial penalties.
If you continue to work for a company employing 20 or more people after you turn 65, you could delay your Medicare enrollment. Your employee group plan provides enough medical coverage while youre working, meaning you may be able to wait to sign up for Medicare once you retire without incurring any late penalties.
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No, your Original Medicare benefits will not change when you turn 65. All of the Part A and Part B coverage you have had for the last decade will stay as is.
What may change, however, are your options for private Medicare insurance, such as Medicare Advantage plans, standalone Medicare Part D prescription drug plans or Medicare Supplement plans.
Only 10 states require insurance companies to sell Medigap plans to beneficiaries under 65 in 2020 .
Note: Medicare Advantage plans and Medicare Supplement plans arent the same thing. They work in very different ways, and you cannot have both types of coverage at the same time.
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Should I Sign Up For Medicare When I Turn 65
The popular perception is that your 65th birthday marks the milestone in your life when you get to walk out the office, kick back and reap the fruits of your labor as you enjoy sunsets from your porch.
For some, that perception is becoming a thing of the past.
Nowadays, many people turning 65 and reaching Medicare eligibility are choosing to keep working. Some do it for financial reasons and others continue to work simply because they enjoy it.
The number of Americans 65 and older who said they were employed or looking for employment has increased from 10 percent in 1985 to 20 percent as of February 2019. And that number is expected to continue to rise according to the data from the Current Population Survey, a report by the U.S. Bureau of Labor Statistics. The Bureau estimates that by 2024, more than 13 million Americans 65 and older will be working.1
But regardless of why you may choose to work past 65, not enrolling in Medicare during the right enrollment period could cost you in the form of Medicare premium penalties if you miss certain dates. So its important to approach the decision to delay enrolling with your eyes wide open.
Here are some important points to keep in mind as you approach your 65th birthday.
You’re Still Working And Have Access To A Group Health Plan
Just because you’re turning 65 doesn’t mean you’re on the cusp on retirement. You may still have plans to work another few years — or longer.
If you have access to a group health insurance plan through your employer, and you’re happy with that coverage, then enrolling in Medicare doesn’t make sense — especially if it will cost you more than what you currently pay for insurance. As long as your company’s group health plan covers 20 or more people, you won’t face penalties for missing your initial Medicare enrollment window. Rather, you’ll get a special enrollment period that will begin once you no longer have your group health plan.
Now if you still have access to a great health plan but are turning 65, you may want to consider signing up for Medicare Part A, which covers hospital care. Part A, unlike Part B, is generally free for enrollees. And if you put that coverage in place, Part A can be your secondary insurance for hospital care — and potentially pick up costs that your primary insurance doesn’t cover.
The only caveat here is that once you enroll in any part of Medicare — whether it’s coverage you pay for or not — you’ll no longer be eligible to participate in a health savings account . HSAs offer a number of tax breaks, so if you’re currently funding one, you may want to hold off on signing up for Medicare — even Part A.
Do I Need To Get Medicare Drug Coverage
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.
Even if you have a Special Enrollment Period to join a plan after you first get Medicare, you might have to pay the Part D late enrollment penalty. To avoid the Part D late enrollment penalty, dont go 63 days or more in a row without Medicare drug coverage or other .
If you have other drug coverage: Ask your drug plan if its creditable drug coverage.
Each year, your plan must tell you if your non-Medicare drug coverage is creditable coverage. Keep this information you may need it when youre ready to join a Medicare drug plan.
Who Should Sign Up At 65 Even If They Have Other Insurance
This leaves a fairly long list of other types of insurance that become secondary payers to Medicare. Therefore, if you’re turning 65 and any of these situations apply to you, you should sign up for Medicare during your initial enrollment period.
- You have group coverage through your or your spouse’s employer, but the employer has fewer than 20 workers.
- You have retiree coverage, either through your former employer or your spouse’s former employer.
- You have group coverage through COBRA.
- You have TRICARE, the healthcare program for military service members, retirees, and their families. Retired service members must get Medicare Part B when eligible in order to keep their TRICARE coverage.
- You have veterans’ benefits.
- You have coverage through the healthcare marketplace or have other private insurance. Once your Medicare coverage begins, you’ll no longer get any reduced premium or tax credit for marketplace coverage, and you should drop this coverage as you’ll no longer need it .
If one of these situations applies to you and you don’t sign up for Medicare Part B during your initial enrollment period, you could face permanently higher premiums when you do.
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Can I Still Work And Have Medicare At The Same Time
Yes, but you will not be automatically enrolled in Medicare if you are not claiming Social Security benefits. As long as your workplace insurance covers your needs, you are free to stick with it. However, it’s important to consider the size of your company and take advantage of Medicare coverage if you’ve earned it through all your years as a taxpayer.
Do You Have To Sign Up For Medicare If You Are Still Working
The most common reason for people not signing up for Medicare when they turn 65 is because they are still working. Because theyre still working, theyre likely covered under their employers health insurance plan and are also unlikely to be collecting Social Security retirement benefits.
Being covered under your employer-provided health insurance plan has no bearing on your Medicare eligibility. Medicare works in conjunction with several other types of health insurance including health insurance provided by employers or unions and wont prevent you from enrolling.
However, if you are not collecting Social Security retirement benefits at least four months before you turn 65, you will not be automatically enrolled in Medicare when you turn 65. In this case, you will have to manually sign up for Medicare when youre ready to enroll.
Many people choose to delay their Social Security retirement benefits until a later age when they can collect the full amount. If you choose to delay your retirement benefits, you must still sign up for Medicare manually once youre eligible in order to avoid any late enrollment penalties .
Some people who are still working sign up for Medicare anyway, because Medicare can work as extra insurance along with an employer group health insurance plan. Some people may decide that Medicare is more affordable than their employers insurance, so they may continue working but disenroll from their group plan and enroll in Medicare instead.
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What If Your Medicare Card Didnt Arrive
If youre expecting to receive a Medicare card but havent yet received one three months before your 65th birthday, the first thing to do is to not worry. Medicare sends out hundreds of thousands of cards per year without issue. Its possible for the card to be delayed or for there to be an error. To confirm whether a Medicare card is heading your way, check with your local Social Security office to make sure that youre enrolled.
Enrollment In Medicare Advantage And Part D
Unlike Original Medicare, there is no option for automatic enrollment with these plans. For Part D, you can enroll during the Annual Enrollment Period from October 15th through December 7th if you miss your IEP.
For enrollment in a Medicare Advantage plan , you can also use the same Annual Enrollment Period.
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How Social Security Benefits Can Affect Medicare Enrollment
If you are receiving Social Security benefits when you turn 65, youll be automatically enrolled in Medicare Parts A and B, even if youre working. Your Medicare card will arrive in the mail about 3 months before your 65th birthday.
Once youre enrolled in Medicare, a monthly Part B premium will be automatically deducted from your Social Security check. If you dont want Medicare Part B, you need to notify Medicare to opt out. There will be instructions for doing this on the back of your Medicare card.
If youre not receiving Social Security or Railroad Retirement Board benefits, you will need to enroll yourself in Medicare when you become eligible.
Medicare Part B Premiums And Deductibles
In 2021, the Medicare Part B monthly premium is $148.50 if you earn up to $88,000 as a single income tax filer or $176,000 as a married filer.
The Part B deductible is $203 for 2021. Please note that premiums increase in tiers at higher income levels.
For 2022, the Part B monthly premium is $170.10 if you earn up to $91,000 as a single income tax filer or $182,000 as a married filer. The 2022 deductible is $233 for the year.
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Special Situations: Previous Employers Military Vets
If you have health insurance from a previous employer, such as your or your spouses COBRA or retiree health coverage, you need to enroll in Medicare Parts A and B when you turn 65.
If you have health benefits as a military service member or veteran, such as TRICARE or CHAMPVA, you should consult with those programs to determine when to enroll in Medicare.
Its complicated, so get all the advice you need.
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.
About the author:John Rossheim is an editor and writer specializing in health care and workforce trends. His work has appeared in The Washington Post and on MSN, Monster and dozens of other websites.Read more