Thursday, November 24, 2022

Must I Take Medicare At 65

Don't Miss

Reaching Age 62 Can Affect Your Spouse’s Medicare Premiums

Do I have to Enroll in Medicare at 65?

Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.

When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they havent yet qualified based on their own work history.

  • For example, Gerald is 65 years old, but he doesnt qualify for premium-free Part A because he did not work the minimum number of years required for eligibility. He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.
  • Lets say Geralds wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.

In the above example, Jessica has not become eligible for Medicare by turning 62. Her husband Gerald, however, is now eligible to receive his Medicare Part A benefits without paying a monthly premium any longer.

A Late Enrollment Penalty

You’d only be subject to a Part A late enrollment penalty if you’re not eligible for premium-free Part A coverage. Most Americans don’t have to worry about this, as they have at least ten years of work history, or are/were married to someone who does. But if you’d have to pay a premium to buy Part A coverage, there’s a penalty if you delay your enrollment.

The penalty is a 10% increase in your monthly premium. In 2020, the Part A premium is $458/month for people with 0-29 quarters of work history, and $252/month for people with 30-39 quarters of work history. So those premium amounts would increase to $504/month and $277/month, respectively, if you’re subject to the late enrollment penalty.

But unlike the penalties for Part B and Part D, the penalty for late enrollment in Part A does not last forever. Instead, you’d pay it for twice as long as the amount of time you delayed your enrollment. So if you were eligible for Medicare for three years before enrolling, you’d have to pay the extra Part A premiums for six years. Keep in mind that the Part A premium changes each year , so the actual amount you’d be paying would vary for each of those six years.

The Problem With Missing Your Enrollment Deadline

Most Medicare enrollees don’t pay a premium for Part A, which covers hospital visits. However, they do pay for Part B, which covers preventative care and diagnostic services. Currently, the standard Part B premium is $134 . If you don’t sign up for Medicare during your initial enrollment window, you’ll face a 10% increase in your Part B premiums for every year-long period you’re eligible for coverage but don’t enroll. Therefore, it generally pays to sign up for Medicare at 65 — unless you happen to qualify for one major exception.

You May Like: Does Medicare Cover Dexa Scan

At What Age Do I Qualify For Social Security

You can begin collecting Social Security retirement benefits as early as age 62. Doing so, however, is often not advisable, since it means lowering your monthly benefits potentially for life.

To collect the full monthly benefit your earnings record entitles you to, you must wait until full retirement age to sign up for Social Security. Depending on your year of birth, that age will fall out somewhere between 66 and 67. For each month you file for Social Security ahead of full retirement age, youll face a reduction in your monthly benefits that will likely remain in effect indefinitely, unless you manage to go through the motions of withdrawing your application soon after filing it.

Medicare Eligibility For People Under 62

Must I take Medicare if I receive Social Security?

There are a few exceptions for Medicare age limits that can allow people younger than 65 and under age 62 to enroll in Medicare.

  • If you have ALS , you are immediately eligible for Medicare regardless of your age as soon as your Social Security or Railroad Retirement Board disability benefits begin.
  • You may also qualify for Medicare if you have kidney failure that requires dialysis or a kidney transplant, which is known as end-stage renal disease .
  • You may also qualify for Medicare at age 62 or any age before 65 if you receive disability benefits from either Social Security or the Railroad Retirement Board for at least 24 months.

If you qualify for Medicare under the age of 65 because of a disability, you might also qualify for a Medicare Advantage Special Needs Plan.

You May Like: When Can You Apply For Part B Medicare

When Do You Apply For Original Medicare

You might not even have to apply for Original Medicare, which includes Part A and Part B . Many people are enrolled automatically. That applies to you if youre already getting Social Security benefits when you turn 65.

But even if youre automatically enrolled in traditional Medicare, you do have to take action if you want other Medicare coverage. For example, say you want to buy a Medicare Supplement insurance plan. The government doesnt enroll you. You need to do that if thats what you want. Well get into this more later on.

When Can You Enroll In Medicare

You can apply for Medicare during three distinct enrollment periods: your Initial Enrollment Period, the General Enrollment Period and a Special Enrollment Period when youre getting off your employers health coverage.

Medicare Enrollment Dates

Change to a 5-star Medicare Advantage or Part D prescription drug plan.

Don’t Miss: What Is Medicare Part G

How To Sign Up For Medicare Advantage Or Medicare Part D

Original Medicare is a federal government program that doesnt include Medicare Part C or Part D. Simply Healthcare offers Medicare Advantage plans that include prescription drug coverage .

You must have Part A and Part B before signing up for a Medicare Advantage or Part D plan. You can add a Medicare Advantage or prescription drug plan during your Initial Enrollment Period or during the Annual Enrollment Period between October 15 and December 7.

Do I Have To Take Medicare If I Receive Social Security

Turning 65 – What you need to know about enrolling in Medicare

For various reasons, there are some who choose to put off Medicare enrollment when they turn 65. If they also delay Social Security benefits, there will be no problem. However, if they get Social Security but do not enroll in Medicare Part A, there can be problems.

In 2011, a district court decision determined that, if you want Social Security, you must also take Medicare. An appeals court in spring 2011 reaffirmed this decision. Here are some facts from the decision, known as Hall vs. Sebelius.

  • Medicare Part A, hospital insurance, is mandatory for those who receive Social Security, and may have an impact on existing health coverage.
  • A person who does not participate in Medicare Part A must forego all Social Security retirement benefits and repay any benefits already received.
  • Medicare Part B, medical insurance, is an optional benefit. Failing to enroll will not jeopardize Social Security benefits.

Also Check: How Can I Sign Up For Medicare

When Should You Apply For Medicare If You Have Employer Health Coverage

Most people should sign up for Medicare Part A when theyre first eligible because it rarely costs anything. But some people delay enrolling in Part B because they dont want to pay the monthly premium. The decision usually depends on the type of health coverage you already have.

You can put off enrolling in Part B at age 65 if you have group health coverage through your or your spouses job and the employer has at least 20 employees.6 Youll be able to enroll with no penalty during the Special Enrollment Period that follows the end of your employers insurance. You can also choose to enroll in Part B while still insured and pay the premium.

If your employer has fewer than 20 employees, you should apply for Part A and Part B as soon as youre eligible.7

Be sure to talk to your employers benefits administrator about how signing up for Medicare will affect your coverage or Health Savings Account .8 You cannot contribute to an HSA if you have Medicare Part A. Your administrator can help you time the beginning and end of your coverage through work and your new health insurance so theres no gap in your coverage.

When your group coverage is ending, youll need to complete documentation and submit it to your Social Security office. If you have questions, ask Social Security.

Delaying Enrollment Could Result In A Permanent Penalty

As described above, you can’t reject premium-free Medicare Part A without also giving up your Social Security benefits. But since your work history is allowing you access to Medicare Part A without any premiums, few people consider rejecting Part A coverage.

The other parts of Medicare, however, do involve premiums that you have to pay in order to keep the coverage in force. That includes Medicare Part B and Part D , as well as supplemental Medigap plans. Medicare Part C, otherwise known as Medicare Advantage, wraps all of the coverage into one plan and includes premiums for Part B as well as the Medicare Advantage plan itself.

So it’s understandable that some Medicare-eligible people, who are healthy and not using much in the way of medical services, might not want to enroll in Part D and/or Part B. Similarly, people who are eligible for Part A but with premiums might want to avoid enrolling in order to save money on premiums. But before deciding to postpone enrollment in any part of Medicare, it’s important to understand the penalties and the enrollment limitations that will apply if you decide to enroll in the future.

There are penalties associated with delaying your Medicare enrollment unless the reason you’re delaying is that you are still working and you’re covered by the employer’s health plan. If that’s the case, you’ll be eligible for a special enrollment period to sign up for Medicare when you eventually retire.

Read Also: Can I Get Medicare At Age 62

How Do I Apply For Traditional Medicare

If youre not automatically enrolled in Medicare Part A and Part B, you need to sign up. You should enroll during your IEP, or a Special Enrollment Period if you qualify for one. As mentioned above, one example of a Special Enrollment Period might be if you delayed enrollment in Medicare Part A and/or Part B because you had employer coverage.

You typically sign up for Medicare through the Social Security Administration . You can go to the website at ssa.gov. Or, go in person to a Social Security office. You can reach the SSA at 1-800-772-1213 . Representatives are available Monday through Friday, from 7AM to 7PM, in all U.S. time zones.

Documents You Need To Apply For Medicare

How to Sign Up for Medicare

To begin the application process, youll need to ensure you have the following documentation to prove identity:

  • A copy of your birth certificate
  • Your drivers license or state I.D. card
  • Proof of U.S. citizenship or proof of legal residency

You may need additional documents as well. Make sure to have on hand:

  • Your Social Security card
  • W-2 forms if still active in employment
  • Military discharge documents if you previously served in the U.S. military before 1968
  • Information about current health insurance types and coverage dates

If you are already enrolled in Part A and have chosen to delay enrollment in Part B, you will need to complete additional forms .

  • 40B form: This form allows you to apply for enrollment into Part B only. The 40B form must be included in your online application or mailed directly to the Social Security office.
  • L564 form: Your employer must complete this form if you delayed Part B due to creditable group coverage through a said employer. The completed L564 form also must be included in your online application or mailed directly to the Social Security office.
  • Don’t Miss: When Can Medicare Plans Be Changed

    Can A 62 Year Old Get Medicaid

    Yes. Medicaid qualification is based on income, not age. While Medicaid eligibility differs from one state to another, it is typically available to people of lower incomes and resources including pregnant women, the disabled, the elderly and children.

    Learn more about the difference between Medicare and Medicaid.

    How To Apply For Medicare

    Medicare enrollment is easier than ever. Once you meet eligibility requirements, you are ready to choose from a variety of plans in which to enroll. As we mentioned earlier, some beneficiaries can receive automatic enrollment, and some have to apply manually.

    There are three ways to apply for Medicare Part A and Part B:

  • Fill out an online application at SSA.gov
  • Visit a local Social Security office in person
  • If you have previously been a railroad employee, you can enroll in Medicare by contacting the Railroad Retirement Board, Monday Friday, from 9:00 AM 3:30 PM at 1-877-772-5772.

    Medicare applications generally take between 30-60 days to obtain approval.

    Also Check: Does Medicare Pay For Mens Diapers

    The Medicare Drug Subsidy That Millions Of Enrollees Overlook

    Once youve set up separate formularies for you and your wife, Plan Finder will tell you the projected out-of-pocket expenses for 2015 for all the plans offered in the ZIP code where you live. This is a powerful shopping tool but, yes, it will take some time.

    You may already have a Part D plan that you like. And you may be able to view its formulary on your plans website or get a printed copy from your plan. But this is, after all, Medicare open enrollment season , so I am pushing comparison shopping today. You might be surprised at how much money you could save by switching to another plan.

    Your monthly costs will depend, of course, on the precise drugs you and your wife need to take. There also could be what I call a convenience factor at work here. More and more drug plans are doing preferential deals with big drugstore chains. The insurer and, to a lesser extent, you, get better drug prices and the chain gets preferred access to consumers. Drug plans with these deals may charge higher prices if you get your prescriptions filled at a pharmacy thats not part of its preferred network. Your favorite neighborhood pharmacy could be the odd man out here. You need to consider if thats OK or if youre willing to pay extra for convenience and to keep hearing your pharmacist laugh at your stale old jokes.

    Some Retiree Health Plans Terminate At Age 65

    Understanding Medicare at 65 Video #3 – Medigap & Standalone Drug Plans

    If you’re not yet 65 but are retired and receiving retiree health benefits from your former employer, make sure you’re aware of the employer’s rules regarding Medicare. Some employers don’t continue to offer retiree health coverage for former employees once they turn 65, opting instead for retirees to transition to being covered solely by Medicare. Without coverage from your company, you’ll need Medicare to ensure that you are covered for potential health issues that arise as you age.

    Also Check: What Age Can You Start To Collect Medicare

    Medicare Part B Monthly Premiums During 2020

    The important point for federal employees continuing to work in federal service past age 65 with FEHB insurance coverage is that they need not enroll in Part B until after they retire from federal service.

    The reason for this delay in enrolling in Part B is threefold:

    First, while continuing to work in federal service the employees FEHB insurance coverage will always be considered primary coverage and the employee has access to a HCFSA to help whatever is not paid or reimbursed through the FEHB health plan.

    Second, while working the employees MAGI will most probably be larger compared to the MAGI in retirement and the employee would likely pay much more for Part B.

    Third, the employee can enroll in Medicare Part B once he or she retires from federal service and not be subject to a late enrollment penalty provided the retired employee within 8 months following the employees retirement from federal service.

    What Steps Should Employees Working Past Age 65 Take with Medicare Once They Retire from Federal Service?

    Given that most federal employees working past age 65 are already enrolled in Medicare Part A, it is recommended these employees once retired enroll in Medicare Part B. To avoid a late enrollment penalty, they need to enroll in Medicare Part B within 8 months following their retirement date from federal service. In particular, they must do the following:

    The following example illustrates:

    How Much Does Medicare Cost At Age 65

    The United States national health insurance program known as Medicare has been providing people with health care insurance coverage since 1966. Today, Medicare provides this coverage for over 64 million beneficiaries, most of whom are 65 years and older.

    The U.S. government has set the age of eligibility for Original Medicare Parts A and B at 65. And, while most people enroll at this age, others continue working and choose to stay on their employers insurance plan until the time they retire.

    If your 65th birthday is coming up and you are planning to enroll for your Medicare benefits, you may be wondering what your costs will be. Here is a look at what you pay for Medicare insurance at the age of 65.

    What Medicare costs do you have at age 65?The four parts of Medicare have their own premiums, deductibles, copays, and/or coinsurance costs. Here is a look at each part separately to see what your costs may be at age 65.

    Part A

    If you are not receiving Social Security benefits three months before your 65th birthday, you must sign up for Part A during your initial enrollment period which lasts for a period of seven months based on your 65th birth month.

    There is no monthly premium for Part A if you meet the following requirements for premium-free Part A:

    You are currently receiving retirement benefits from either the SSA or the RRB.

    You have not applied for SS or RRB benefits yet, but you are eligible for them.

    Days 1 60: $0 coinsurance per benefit period

    Part B

    Recommended Reading: Does Medicare Require A Referral For A Colonoscopy

    More articles

    Popular Articles