Do I Need to Enroll In Medicare If I’m Still Working at 65?

You have turned 65 and you are still working so you are not sure when is the right time to enroll in Medicare program?  Don’t worry because you have come to the right place! In this blog, we will answer all of your questions about Medicare enrollment.  Let’s dive into it.

Medicare eligible but still working-what to do?

More and more Americans are working past the age of 65 so the common question that Medicare Insurance agents get is “when is the right time to enroll in Medicare?

The first thing that we need to discuss is that it’s a little bit different if you work in a company with more than twenty employees or in a company with fewer than twenty employees. 

So, if your employer has 19 or fewer employees Medicare would generally pay first so if you are working in that kind of a company we recommend you drop out of your group plan and get into Medicare because Medicare will become primary and the group plan will become secondary. There is no reason for you to have secondary coverage with Medicare. 

However, if you work at a larger company that has 20 or more employees, your group health plan is a primary source of coverage and Medicare is a secondary source of coverage. In that case, it is better to stay on your group health plan because you don’t need both of them- they simply don’t coordinate well. 

For example, if you have a good group insurance plan with decent coinsurance, and deductible you will probably want to stay on your group insurance health plan, especially because your employer probably pays for most of your monthly premium until you’re ready to retire.

You are deciding to stay on your group plan after the age of 65?

So, if you work at a good company with more than 20 employees and that company is providing a plan with good healthcare benefits there is no reason for you to quit your group health plan, but you are wondering what is next? Don’t worry we will break it down for you to avoid any confusion.

It is important to understand that your Medicare Part A kicks in when you turn 65 because you will be automatically enrolled in Part A when you become of age. 

But, with Medicare Part B you need to be careful. If you want to stay on your group health plan do not enroll in Medicare Part B before you are ready to retire. 

Reasons why you should not enroll in Part B before retirement:

  • Medicare Part B monthly premium: you don’t want to pay for Part B premium if you don’t need it 
  • If you start Part B it acts like you are turning 65: for example, you don’t start Part B while you are still working and you want to retire, let’s say at age 70. Your Part B will act like you are enrolling for the first time so you will have open window enrollment and you can pick anything you want in Medicare without any healthcare questions 

Therefore, do not enroll in Part B before you are ready to take Medicare as your primary source of coverage.

What should I do when I want to retire?

When you are ready to take Medicare as your primary source of coverage and are ready to retire there are some important things you need to know before you do so. Let’s dive into it.

First, you will need to get your employer’s coverage form because it shows that you had credible coverage before Medicare so you will not need to pay for Part B and Part D (prescription drug coverage)  late enrollment penalties. This is important for every beneficiary and it can take time so make sure that you fill out your needed documents earlier to have everything prepared for a special Part B enrollment period.

However, you have up to eight months after your group coverage or your employment ends to enroll in Part B without a penalty (COBRA coverage and retiree benefits don’t count). This is valid for your coverage or your spouse’s coverage.

But usually, you want to enroll as soon as you lose group health coverage to avoid any gaps in it.  When you want to enroll consider submitting two types of forms (CMS 40-B Medicare enrollment form and CMS-564 – this is the employer form we talked about earlier in the article) to your local Security Office. In form CMS 40- B you can write in the comment section when would you like for your coverage to begin. 

Medicare is obligatory to honor your special enrollment period as long as you provide them with those two forms. It is important two have signed proof of your former group coverage by your employer.  Also, this is important for you if you want to enroll in a stand-alone Part D plan– you’ll also need proof of former creditable coverage to avoid the Part D late enrollment penalty as discussed before, so keep that in mind. 

We know that Medicare can be complicated for new beneficiaries but you are definitely not alone. Experienced Medicare insurance agents are here because of you so if you have additional questions about Medicare enrollment talk to our brokers here in Missouri Insurance Advisors. We are experts in the Medicare world and we will be happy to help you with any of the questions you might have.

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