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If you are approaching age 65 and still working, you may be wondering whether to enroll in Medicare or continue with your employer’s health coverage.
The answer depends on several factors, including your employer’s size, the cost of your employer’s plan, and how Medicare coordinates with your existing coverage.
Understanding your options can help you avoid unnecessary costs or late enrollment penalties.
When You Can Delay Medicare
If you are still working and your employer has 20 or more employees, you may be able to delay enrolling in Medicare Part B without a penalty as long as you have creditable employer health coverage.
This rule also applies if you receive coverage through your spouse’s employer plan.
When your employment or employer coverage ends, you will have a Special Enrollment Period of 8 months to enroll in Medicare Part B.
Many individuals still choose to enroll in Medicare Part A, which is usually premium-free for those who qualify.
When You Should Enroll at Age 65
To delay enrolling in Medicare Part B, your current employer health plan must be considered creditable coverage. The following types of coverage are not considered creditable for delaying Medicare:
- COBRA
- Retiree Insurance
- VA Coverage
- Individual Health Insurance
In these situations, it is usually recommended that you enroll in both Medicare Part A and Part B when you first become eligible.
How Medicare Works with Employer Coverage
If you have both Medicare and employer health insurance, the plans will coordinate benefits. One plan will pay first.
- The plan that pays first is called the primary payer
- The second plan is called the secondary payer
Employers with 20 or More Employees
Your employer health plan pays first, and Medicare becomes secondary.
Employers with Fewer Than 20 Employees
Medicare pays first, and your employer plan becomes secondary.
Get Help Reviewing Your Medicare Options
Deciding whether to enroll in Medicare while you still have employer coverage can feel complicated. A personalized review can help you understand your choices and avoid costly mistakes.
We’re here to provide clear guidance so you can move forward with confidence.
By Juliana Souza, President of Coastal Healthcare Group.
