65 and still working?
There are many things to consider when you are still working and on your employer’s health insurance. I will explain how it works, review your options, and together we can decide the best strategy for the remainder of your working years. See below for commonly asked questions regarding working at 65....
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Commonly Asked Questions...
See below for answers to commonly asked questions Regarding Employer Health Insurance and Medicare.
Do I need Medicare Part B if I have Employer Health Insurance?
Whether you need Medicare Part B when you have employer health insurance depends on various factors, such as the size of your employer and the type of coverage they offer. Here are some general guidelines:
1.    Employer Size: If you work for an employer with 20 or more employees, your employer's health insurance plan is considered primary, and Medicare is secondary. In this case, you may delay enrolling in Medicare Part B without facing penalties as long as you have credible coverage through your employer.
2.    Employer Coverage: If your employer's health insurance is comprehensive and meets Medicare's standards for creditable coverage, you may not need to enroll in Part B immediately. However, it's essential to check with your benefits administrator to ensure your coverage meets Medicare's requirements.
Part-Time Work: If you have health insurance through an employer where you work part-time, Medicare may be your primary coverage, and you might need to enroll in Part B when you become eligible.
Retirement: When you retire or lose your employer coverage, you generally have a Special Enrollment Period (SEP) during which you can sign up for Medicare Part B without penalty.
It's crucial to understand your specific situation and consider factors such as the cost, coverage, and timing of enrollment in Medicare Part B. You may want to consult with a Medicare advisor (such as myself) or your employer's benefits coordinator to make an informed decision.
Is Employer Health Insurance Primary over Medicare?
Yes, in most cases, employer health insurance is considered primary over Medicare. This means that if you have both employer health insurance and Medicare coverage, your employer's plan pays your medical bills first, and Medicare may pay some or all of the remaining costs, depending on the specific circumstances.
However, there are exceptions to this general rule, such as if you work for a small employer with fewer than 20 employees, in which case Medicare may be primary. It's essential to understand your specific situation and how your employer's health insurance interacts with Medicare.
If you have questions about whether your employer health insurance is primary or secondary to Medicare, it's a good idea to check with your employer's benefits administrator or with Medicare directly for clarification.
How Does Medicare Work with Other Insurance?
Medicare works with other insurance in various ways, depending on the type of coverage you have. Here's a general overview:
1.    Employer Health Insurance: As stated above, if you have health insurance through your or your spouse's current employer and the employer has 20 or more employees, the employer's insurance is typically primary, and Medicare is secondary. This means that your employer's plan pays your medical bills first, and Medicare may pay some or all of the remaining costs. If you have retiree health benefits from a former employer, Medicare may coordinate with that coverage as well.
2.    Medicaid: If you're eligible for both Medicare and Medicaid, Medicaid may help pay for costs that Medicare doesn't cover, such as copayments, deductibles, and premiums.
3.    Medicare Supplement Insurance (Medigap): If you have a Medigap policy, it helps pay for some Medicare costs, such as copayments, coinsurance, and deductibles. Medigap policies work with Original Medicare.
4.    Medicare Advantage Plans (Part C): These plans provide all your Medicare Part A and Part B coverage and often include additional benefits, such as prescription drug coverage (Part D), dental, vision, and hearing benefits.
5.    Veterans Benefits: If you're a veteran receiving VA benefits, you can use both VA benefits and Medicare. They generally do not coordinate benefits, but you can use them together to get additional coverage.
6.    TRICARE: If you have TRICARE, it typically works with Medicare. TRICARE for Life acts as a supplement to Medicare, covering expenses that Medicare doesn't cover.
It's essential to understand how your various insurance plans work together to ensure you get the most coverage and benefits. If you have questions about how Medicare coordinates with your other insurance, you can contact a Medicare Advisor like myself, Medicare, or your insurance providers for more information.
What happens if you don't enroll in Medicare at 65?
If you don't enroll in Medicare at age 65 and you're eligible, you may face penalties or gaps in coverage depending on your circumstances:
Late Enrollment Penalties: If you don't sign up for Medicare Part B (and, if applicable, Part D or a Medicare Advantage plan) when you're first eligible at age 65, you may incur a late enrollment penalty. This penalty typically results in a permanent increase in your monthly premium for Part B and, if applicable, Part D coverage.
Coverage Gaps: If you delay enrolling in Medicare, you may have gaps in coverage if you're not covered by another health insurance plan. This could leave you responsible for paying out-of-pocket for medical expenses until you enroll in Medicare.
Simalarly, by not enrolling in Medicare when you're first eligible, you may be subject to Late enrollment Penalties described above.
Limited Enrollment Periods: If you miss your initial enrollment period when you turn 65, you'll have to wait for the General Enrollment Period (January 1 - March 31 each year) to sign up for Medicare Part A and/or Part B. Coverage will start July 1 of that year, and you may still incur late enrollment penalties.
However, there are some exceptions to these penalties and coverage gaps, such as if you have coverage through an employer with 20 or more employees, in which case you may be able to delay enrolling in Medicare without penalties until you retire or lose your employer coverage.
It's essential to understand your Medicare eligibility and enrollment deadlines to avoid penalties and ensure you have the health coverage you need when you need it.
Can I delay Medicare Part B if I am still working?
Yes, you can delay enrolling in Medicare Part B if you're still working and have health insurance through your employer or your spouse's employer, provided that the employer has 20 or more employees. In this case, your employer's group health plan is considered primary, and Medicare would be secondary.
If you're eligible for premium-free Medicare Part A (which covers hospital stays), you may enroll in Part A without enrolling in Part B. However, if you delay enrolling in Part B because you have employer coverage, you'll qualify for a Special Enrollment Period (SEP) to enroll in Part B when your employer coverage ends or when you decide to retire.