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
Im Working Past 65 But My Health Coverage Is From My Spouses Employer
A pretty common situation to face, if your health care coverage is from a spouses employer, you may be able to delay Medicare or you may need to enroll when you first become eligible. In this case, the employer still needs to have 20 or more employees. However, the big difference is thatemployers can have rules for covered dependents 65 and older that may require the individual to get Medicare at 65 in order to remain on the employer plan.
Therefore, if you have employer coverage through a spouses employer, you need to ask the employers benefits administrator directly about your Medicare enrollment choices.
Should You Wait Until 65 To Sign Up For Medicare
If you wait to sign up right before your 65th birthday , you may go for months without coverage.
Initial Enrollment Period
Your Initial Enrollment Period will last for 7 months. This Initial Enrollment Period begins 3 months before the month of your 65th birthday and ends 3 months after your birthday month. If you fail to enroll before your birthday month, your coverage will be delayed by a month or more.
General Enrollment Period
Youll have the option to sign up during the General Enrollment Period which falls between January 1 and March 31 every year if you didnt sign up during the Initial Enrollment Period. But youll potentially be charged a late enrollment penalty. Your premiums for Part B will be permanently increased by 10% for each year that you neglected to sign up for Part B and your monthly premiums for Part A will temporarily increase by 10%. As a rule, most people dont pay premiums for Part A, but then again, most people dont delay signing up for Part A. Your coverage will start on July 1, three months after the General Enrollment Period ends.
You may be able to avoid the late enrollment penalty and having to wait for the General Enrollment Period if you qualify for a Special Enrollment Period.
Special Enrollment Period
Its important to check with your insurer or HR department to make sure that your coverage is sufficient to postpone Medicare enrollment.
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Sign Up: Within 8 Months After You Or Your Spouse Stopped Working
Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
The Cost Equation: Will Medicare Save You Money
If your employer requires you to pay a large portion of the premium on your group health insurance, you may find Medicare cheaper and the coverage adequate. So compare your current coverage and out-of-pocket expenses including premiums, deductibles, copays and coinsurance with your costs and benefits under Medicare, which may also pay some expenses not covered by your group plan.
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How To Apply For Medicare Part A And Part B Before Age 65
Some people are automatically enrolled in Original Medicare. If youve been receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months in a row, you will be automatically enrolled in Original Medicare, Part A and Part B, when you reach the 25th month.
If you have ALS or Lou Gehrigs disease, youre automatically enrolled in Medicare the month you begin receiving your Social Security disability benefits.
Some people will need to sign up for Medicare themselves. If you have end-stage renal disease , and you would like to enroll in Medicare Part A and Part B, you will need to sign up by visiting your local Social Security Office or calling Social Security at 1-800-772-1213 . If you worked for a railroad, please contact the RRB to enroll by calling 1-877-772-5772 , Monday through Friday, 9 AM to 3:30 PM, to speak to an RRB representative.
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Medicare Eligibility Age Requirements
So, at what age can you get Medicare? There are a couple of requirements that must be met for you to qualify for Medicare. First, you must be 65 or older. Next, you must be a U.S. citizen or permanent resident. Younger individuals may qualify for Medicare, but they must meet one of the disability criteria, like kidney failure, mentioned in the previous section.
Your initial enrollment period for Medicare benefits begins three months before the month in which you turn 65. It runs through your birthday month and covers three months past your birthday month. During this time, you can enroll in Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D without any late enrollment penalties. Since Medicare Part B carries a monthly premium, you might decide to opt out of this coverage. However, signing up for Part B coverage later might require the payment of a late penalty unless you qualify for a special enrollment period.
If you are already receiving benefits from the Social Security Administration or Railroad Retirement Board upon reaching the age of 65, you will be automatically enrolled in Medicare coverage. Remember that the Medicare age and Social Security retirement age are not the same. The full retirement age for Social Security is 66 or 67 for most people. If you are not already receiving your Social Security benefits, you will need to apply for Medicare when you turn 65.
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How Do You Get Medicare At Age 65
When youâre eligible for Medicare at 65, you might be automatically enrolled in traditional Medicare, also called Original Medicare, Part A and Part B. Medicare for your spouse will happen later, when she or he turns 65.
If youâre aging into Medicare at age 65, you can still help with Medicare planning for your spouse. Together, you can learn about Medicare. For example, find out when to apply for Medicare.
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.
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Your Medicare Choices When Working
You have a number of Medicare decisions to make when you turn 65 and this is especially true when you have other health insurance. Its a good idea to start learning about your choices ahead of turning 65. Preparation can help you get the coverage that best meets your needs while avoiding unnecessary costs and give you the confidence you want in whatever decision you end up with.
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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.
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Do I Need To Enroll At 65 If I Work For A Small Company
The laws that prohibit large companies from requiring Medicare-eligible employees to drop the employer plan and sign up for Medicare do not apply to companies with fewer than 20 people. In this situation, the employer decides.
You generally need to sign up for Medicare Parts A and B during your initial enrollment period, which begins three months before and ends the three months after the month you turn 65. If you dont, you could end up with large coverage gaps.
If the employer does require you to enroll in Medicare, which is most common, Medicare automatically becomes your primary coverage at 65 and the employer plan provides secondary coverage. In other words, Medicare settles your medical bills first, and the group plan pays only for services it covers but Medicare doesnt.
So if you fail to sign up for Medicare when required, you essentially will be left with no coverage.
Extremely important: Ask the employer whether you are required to sign up for Medicare when you turn 65 or are eligible to receive Medicare earlier because of a disability. If so, find out exactly how the employer plan will fit in with Medicare. If youre not required to sign up for Medicare, ask the employer to provide the decision in writing.
When Medicare is primary coverage and the employer plan is secondary, you have the right to buy Medigap later with full federal protections. But you must do so within 63 days of the employer coverage ending.
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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Is Medicare Free At Age 65
Part A is free, as long as you paid Social Security taxes for at least 40 quarters. In other words, you would have needed to work and pay those taxes for at least 10 years.
If you didnt pay the taxes, you will have to pay monthly Part A premiums. People who paid fewer than 30 quarters worth of Social Security taxes must pay $458 monthly for Part A. Those who paid taxes between 30 and 39 quarters pay $252 monthly.
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Medicare Part B: Delay To Avoid Premiums
If youre 65 or older and you or your spouse still have employer health coverage, you will probably want to delay enrolling in Medicare Part B, which pays for doctor visits and many other outpatient services. Why? Because unlike Medicare Part A, everyone pays a premium for Part B, so its never a free add-on.
As with Part A, your particular circumstances can influence your decision, and there are pitfalls to avoid:
If the employer has 20 or more employees: If your or your spouses employer has 20 or more employees and a group health plan, youre not required to sign up for Medicare at age 65. But the clock starts ticking once you stop working or lose your employer coverage , so dont miss your window.
If the employer has fewer than 20 employees: If your or your spouses employer has fewer than 20 employees and the health coverage is not part of a multiemployer group plan, at age 65 you must enroll in Medicare Part B, which will be your primary insurance.
If you have an HSA and want to keep contributing: If you have an HSA and want to continue making contributions to it, you must delay signing up for Medicare Part B. Stop making contributions to your HSA at least six months before you sign up for Part B. And youll want to sign up for Medicare at least a month before you stop work or lose employer coverage.
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If I Retire At Age 62 Will I Be Eligible For Medicare At That Time
Medicare is federal health insurance for people 65 or older, some younger people with disabilities, and people with end-stage kidney disease. Most commonly, you are eligible for Medicare when you turn 65, but there are other health insurance options if you are younger and do not have coverage through you or your spouses employer.
What you should know
|1. The typical age requirement for Medicare is 65, unless you qualify because you have a disability.||2. If you retire before 65, you may be eligible for Social Security benefits starting at age 62, but you are not eligible for Medicare.|
|3. You have options for health insurance if you are too young for Medicare. You may obtain it through your employer, or you can purchase from private-sector insurance companies through the health insurance exchange. You may be eligible for Medicaid, which is based on income.||4. If you retire before you are 65, you may be eligible for employer-provided group health insurance under the Consolidated Omnibus Budget Reconciliation Act .|
Medicare was established in 1965 in order to provide health coverage for seniors who would otherwise not be covered by employer-sponsored health insurance plans. If you retire at the age of 62, you may be eligible for retirement benefits through social security, but early retirement will not make you eligible for Medicare.
Should I Sign Up For Medical Insurance
With our online application, you can sign up for Medicare Part A and Part B. Because you must pay a premium for Part B coverage, you can turn it down.
If youre eligible at age 65, your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.
Note: Important Upcoming Change Rules for 2023 and later: If you accept the automatic enrollment in Medicare Part B or if you sign up during the first three months of your IEP, your coverage will start the month youre first eligible. Beginning January 1, 2023, if you sign up during the month you turn 65 or during the last three months of your IEP, your coverage starts the first day of the month after you sign up.
The following chart shows when your Medicare Part B becomes effective in 2022:
|In 2022, if you sign up during this month of your IEP||Your Part B Medicare coverage starts|
|One to three months before you reach age 65||The month you turn age 65.|
|The month you reach age 65||One month after the month you turn age 65.|
|One month after you reach age 65||Two months after the month of enrollment.|
|Two or three months after you reach age 65||Three months after the month of enrollment.|
The following chart shows when your Medicare Part B becomes effective in 2023:
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