I Am About To Turn 65 My Spouse Is 60 And Still Working We Are Both Covered Under Her Employers Health Plan Do I Have To Do Anything With Regard To Medicare This Year
A person with group health coverage through a current employer may be able to delay enrolling in Part A and Part B until that coverage ends, and wont face penalties for enrolling later, but only if the employer has 20 or more employees. If your wifes employer has at least 20 employees, you may want to enroll in Part A but delay enrollment in Part B until your group coverage through your spouses employer plan ends.
If you are already receiving Social Security benefits, you will be automatically enrolled in Part A and Part B when you turn 65. If you do not want to pay a premium for Part B benefits now because you have comparable coverage under your spouses employer plan, you will need to let Social Security know that you want to delay Medicare Part B enrollment. You can contact Social Security about this beginning three months before you turn 65. Otherwise, Medicare will assume you want to enroll in Part B and the monthly premium will be automatically deducted from your Social Security check.
If the employer has fewer than 20 employees, you should sign up for Part A and Part B when youre first eligible or you will face late enrollment penalties.
If you do delay Part B enrollment because you are covered under your wifes plan, remember to sign up for Part B once her coverage ends. That way, youll have continuous coverage and wont face a late enrollment penalty for Part B.
What If I Have Non
If you have non-retiree health insurance through your or your spouseâs employer when you become eligible, youâll have to choose if you want to enroll in Medicare Parts A, B, and/or D. Ultimately, this decision depends on the type of health coverage you or your spouse currently have and the size of your or your spouseâs employer.
Generally speaking, you should probably enroll in Part A after qualifying for Medicare.
If the employer has fewer than 20 employees, youâll probably want to enroll in Parts A, B, and D upon becoming eligible for them. In this situation, Medicare usually becomes your primary coverage. If the employer has 20 employees or more, you may want to delay Parts A, B, and/or D if you have sufficient group coverage and know you wonât incur late enrollment penalties. Medicare usually pays second to group coverage from larger employers.
If you have any questions, you can always reach out to a licensed agent.
Generally speaking, you should probably enroll in Part A after qualifying for Medicare. For many seniors, Part A is premium-free and acts as great supplementary coverage. In some cases, it may not make sense to enroll in and pay the monthly premiums that come with Parts B and D right away. Before making the decision to delay any part of Medicare, compare the coverage to see if enrolling in it while covered by your current health plan makes sense. If you have any questions, you can always reach out to a licensed agent.
Can I Work And Have Medicare
If you have a group health plan, you can enroll in Medicare when you qualify for it. But, when should you delay Medicare, and how do you avoid a penalty?
Whether theyâre concerned with affording retirement or love their job, Americans are working later in life. In fact, the percentage of older adults working today is the largest since the creation of Medicare in the 1960s.
Some individuals, maybe even you, will still be actively employed upon becoming eligible for Medicare. Can you work full time and enroll in Medicare, and if you choose to not enroll, will you get a penalty?
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Who Is Eligible For Medicare
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
- You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.
If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
- You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
- You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
Can I Decline Medicare Altogether
Medicare isnt exactly mandatory, but it can be complicated to decline. Late enrollment comes with penalties, and some parts of the program are optional to add, like Medicare parts C and D. Medicare parts A and B are the foundation of Medicare, though, and to decline these comes with consequences.
The Social Security Administration oversees the Medicare program, and recommends signing up for Medicare when you are initially eligible, even if you dont plan to retire or use your benefits right away. The exception is when you are still participating in an employer-based health plan, in which case you can sign up for Medicare late, usually without penalty.
While you can decline Medicare altogether, Part A at the very least is premium-free for most people, and wont cost you anything if you elect not to use it. Declining your Medicare Part A and Part B benefits completely is possible, but you are required to withdraw from all of your monthly benefits to do so. This means you can no longer receive Social Security or RRB benefits, and must repay anything you have already received when you withdraw from the program.
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Can You Take Employer Coverage Again When On Medicare
If you return to work for an employer who offers health insurance, you can take it. You are allowed to have both Medicare and employer coverage, and you can use them together. One will act as primary coverage and one will act as secondary.
The only thing to keep in mind is that when you have Medicare and an employer plan, you cannot contribute to a health savings account if its offered.
What Kind Of Treatments Arent Covered By Medicare
A big concern for people in their golden years is maintaining their quality of life and health. But unfortunately, Original Medicare doesnt cover all medical treatments or procedures.
For example, cosmetic and dental procedures arent covered by Original Medicare and this can mean youll have to foot the bill for things like hearing aids, tooth removals, and dentures.
Or if you want to go for specific eye exams, undergo acupuncture treatment, or need routine foot care, Original Medicare wont always cover these costs.
Original Medicare plans don’t cover medical expenses incurred overseas, so if you plan on traveling in your golden years this is something to consider.
With medical expenses adding up quickly, there is no telling what specific treatments, medications, or procedures you may need to ensure your good health over time. The great thing is that you can supplement your Medicare with other insurance plans, such as Medigap cover.
Use thisMedicare coverage list provided by the U.S. government to determine whether your medical test, item, or service falls under claimable Part A or Part B expenses.
Weve also got a list of the top Medigap insurance plans in your state if youre thinking about supplementing your Original Medicare or Medicare Advantage plan.
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When Can I Delay Medicare Without A Penalty
If you have non-retiree group coverage through your employer or your spouseâs employer, you will most likely be able to delay Medicare Parts A, B, and/or D without getting penalized. You could be at risk for receiving late enrollment penalties if:
- If the company you or your spouse works for has under 20 employees and you delay your Medicare coverage
- If you get qualifying coverage through your domestic partnerâs workplace, but arenât married to him or her, and delay your Medicare coverage
- If your employer does not offer and/or you go at least 63 days without creditable drug coverage
How To Opt Out Of Medicare Part B
So, if you dont want to be enrolled, you may be able to opt out. Follow the instructions in your Welcome to Medicare packet, which Medicare sends you during the three months before youre eligible, in most cases.
Were always happy to answer your questions. Call one of our eHealth licensed insurance agents at 1-888-296-0117 . Representatives are available from 8 AM to 8 PM Monday through Friday, and from 10 AM to 7 PM Saturdays, Eastern time.
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What Is A Calendar Quarter
The SSA keeps track of each 3-month quarter a person works and pays their social security and Medicare taxes. Each quarter contributes to a persons eligibility for Medicare Part A.
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 and a secondary payer will only kick in for costs not covered by the primary payer. The secondary payer may not pay all of the remaining uncovered costs, and you may be responsible for any additional balance.
In many instances, if you are age 65 and covered by either a retiree plan or a plan with fewer than 20 employees, then Medicare is your primary payer and private insurance is your secondary. If this is your situation, you should enroll in Part A and B, along with D if your private insurance plan doesnt have creditable prescription drug coverage.
If youre covered by a plan with 20 or more employees, Medicare is often the secondary payer. Medicare may pay costs that your employers plan doesnt.
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Younger Than Age : Who Is Eligible For Medicare
As long as you meet the citizenship/legal residence requirements described above, you may be eligible for Medicare when you are younger than age 65 if one of the following circumstances applies to you:
- You have been receiving Social Security disability benefits for at least 24 months in a row
- You have Lou Gehrigs disease
- You have permanent kidney failure requiring regular dialysis or a kidney transplant. This condition is called end-stage renal disease .
Read more details about enrollment in Medicare when youre under 65.
Can I Get Premium
If you are age 65 or older and pay a premium for your Medicare Part A coverage, you could potentially qualify for premium-free Part A benefits once your spouse turns 62 years old, as long as they paid Medicare taxes for 40 quarters.
For example, Gerald is 65 years old and has to pay a premium for Medicare Part A because he did not work the minimum number of years required for premium-free Part A eligibility.
Geralds wife, Jessica, reaches age 62 and has worked and paid Medicare taxes for 40 quarters. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A, even if Jessica is not currently enrolled in Medicare.
If Jessica reached 65 before Gerald, Gerald would receive premium-free Part A due to her work history once he aged into Medicare.
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How Do You Receive Your Medicare Benefits When You Meet Medicare Eligibility Requirements At Age 65
If you meet Medicare eligibility requirements and you have received Social Security benefits for at least four months prior to turning age 65, you will typically get Medicare Part A and Part B automatically the first day of the month you turn age 65.
If youre not enrolled in Original Medicare automatically, you may need to file an application with the Social Security Administration. You can enroll in Medicare Part A and Part B during the period that begins three months before your 65th birthday month, includes your birthday month and ends three months after your birthday month.
Note: You have a choice if you want to keep or refuse enrollment in Medicare Part B. If you refuse it, you dont lose your Medicare Part B eligibility. However, you may have to wait for a valid enrollment period before you can enroll. You may also have to pay a late enrollment penalty for as long as you have Medicare Part B coverage.
How Much Does Medicare Cost On Disability
If you qualify for SSDI, you’ll typically qualify for premium-free Medicare Part A based on your work record. Part B requires a monthly premium , automatically deducted from your Social Security check. You can technically opt out of Part B if you dont want to pay the premiums. Just know that without Part B, youll forego extensive medical coverage. Its usually not a good idea to opt out of Part B unless you have other health insurancelike from an employer.
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When & How Do I Sign Up For Medicare
You can sign up anytime while you are still working and you have health insurance through that employer. You also have 8 months after you stop working to sign up.
- Your 8-month Special Enrollment Period starts when you stop working, even if you choose COBRA or other coverage thats not Medicare.
- Your coverage will start the month after Social Security gets your completed forms.
To qualify for the Special Enrollment Period, youll need to have your employer fill out a Form CMS-L564 . If the employer cant fill it out, complete Section B of the form as best you can, but dont sign it. Youll need to submit proof of job-based health insurance when you sign up. Forms of job-based health insurance proof:
The way you sign up depends on if you already have Part A coverage or if youre signing up for both Part A and Part B. Get forms and ways to sign up.
Avoid the penalty & gap in coverage
Can You Get Medicare If You Are Still Working
- Your current employment status is not a factor in whether or not youre eligible for Medicare at age 65.
- If you initially decline Medicare coverage, you may have to pay a penalty if you decide to enroll at a later date.
You can get Medicare if youre still working and meet the Medicare eligibility requirements.
You become eligible for Medicare once you turn 65 years old if youre a U.S. citizen or have been a permanent resident for the past 5 years. You can also enroll in Medicare even if youre covered by an employer medical plan.
Read on to learn more about what to do if youre eligible for Medicare and are still employed.
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Medicare Eligibility For Part D
To be eligible for Medicare Part D you must be enrolled in Medicare Part A and/or Part B. You are not eligible for a Part D drug plan if you are enrolled in Medicare Part C. Medicare Part D plans are run by private insurance companies, so premium prices and covered drugs will vary by plan.
You should enroll in a Medicare Part D plan when you are first eligible for Medicare, or risk paying a late enrollment penalty.
Do You Need 40 Quarters To Qualify For Medicare
You do not need to have earned 40 quarters to qualify for Medicare coverage. Medicare eligibility is based primarily on your age .
The number of quarters you paid Medicare taxes will affect your Medicare costs, however. Your Medicare Part A premium is partly based on the number of quarters for which you worked and paid Medicare taxes.
As mentioned above, you qualify for premium-free Medicare Part A if you paid Medicare taxes for 40 quarters. If you paid Medicare taxes for less than 40 quarters, you will typically have to pay a premium for your Part A coverage.
The full breakdown for 2020 Medicare Part A premiums is as follows:
If you paid Medicare taxes for…
…your 2020 Medicare Part A premium will be:
At least 40 quarters
$458 per month
Most Medicare beneficiaries do not pay a premium for their Part A benefits.
You would need to pay Medicare taxes for at least 7.5 years to qualify for the $252 premium in 2020. Anything less than 7.5 years would require you to pay a $458-per-month premium in 2020.
The number of quarters counted do not have to be consecutive in order to count towards your qualified total.