Do You Have to Sign-Up for Medicare at 65 If You’re Still Working?

Do you have to sign up for Medicare at 65 if you are still working or can you delay Medicare enrollment until retirement? That’s what we’re going to talk about in today’s article.

So when it comes to trying to decide about taking Medicare at 65 if you’re still working, the topic can be a little bit confusing. So, first, let’s talk about the Medicare program in general terms.

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Medicare is a Federal Health insurance program primarily for people aged 65 and older, but it’s also available to certain people under 65 with specific disabilities. It’s divided into four parts: Part A, which is hospital insurance; Part B, which is medical insurance; Part C, which is Medicare Advantage; and Part D, which is prescription drug coverage.

Is Medicare Enrollment Automatic?

Here’s the most important thing you need to know: If you took Social Security before your 65th birthday, you will be automatically enrolled in Medicare.

If you have not taken Social Security before turning 65, you have to decide if you will enroll in the program at 65. Now, there is a seven-month window where you can do that around your 65th birthday. It starts three months before your 65th birthday and includes the month of your 65th birthday and the three months after the month of your 65th birthday.

Should I Sign-Up for Medicare I’m Still Working?

So, let’s get to the question at hand. Do you have to sign up for Medicare at 65 if you are still working? The short answer is no. You don’t have to sign up for Medicare if you’re still working, and you can continue to receive healthcare coverage through your employer. Now, there are some things that you want to consider before you make that decision.

The most important thing you can do at this juncture of your life is reach out to the HR person at your employer, whoever handles your medical benefits, and have a conversation with them. Here’s the reason why. There’s a high probability they’ve talked to many other people before you about this exact scenario, and they can be a great resource. An independent insurance broker like myself can also help you.

When deciding between employer coverage and Medicare, it’s essential to consider the size of your employer. If your employer has 20 or more employees, the group health plan typically pays first, and Medicare serves as secondary coverage. Conversely, if your employer has fewer than 20 employees, Medicare becomes the primary payer, and the employer’s plan pays second. In this scenario, enrolling in Medicare Part A and Part B upon turning 65 is advisable to ensure comprehensive coverage. To navigate this transition effectively, consult both your employer’s HR department and a qualified Medicare insurance broker for personalized guidance.

So, once you know those key things about your employer, how they handle people on Medicare, what size the company is, and all of that, you can start to investigate. Okay, if I stay on my employer’s health insurance, what does that get me? So, in other words, what are the premiums? What are the co-payments? Is there co-insurance? Are there deductibles? Is there a maximum deductible for the year? Are there networks?

The reason is that some people have very rich medical benefits from their employer, but for some people, Medicare is going to be a much better option, and in many cases, it can even cost you less than your employer plan. So some investigating and research has to be done. The good news is that you don’t have to do it alone.

Let’s say you go through the whole process and decide, “I’m going to keep my employer coverage, and I’m going to delay Medicare enrollment.” Then what you have to keep in mind is that once you decide to retire or once you lose that benefit from the employer and then you want to apply for Medicare, you will get what’s called a Special Enrollment Period, meaning you’ll be granted the same rights that you would’ve been granted at 65.

What is Creditable Coverage for Medicare?

Now, the vital thing to know is that you will have to provide Medicare with verification that you have credible coverage, and that’s another reason why you want to investigate and find out what your employer’s insurance is. Does Medicare deem it credible coverage? Because then if you delay enrolling in Medicare, and let’s say you get laid off or you retire, or the option is no longer available to you, and then you want to transition fully to the Medicare program, you’re going to want to make sure that you can verify Medicare that you have had credible coverage from your employer.

It’s important to note that even if you’re not working at 65, you still have to enroll in Part B during your initial enrollment period to avoid late penalties. Again, this is if you did not sign up for Social Security when you were eligible. Again, that’s a seven-month window: three months before your 65th birthday, the month of your 65th birthday, and three months after.

Medicare Enrollment after 65

Once you have made those decisions, you can decide whether to transition entirely to Medicare, add a Medicare supplement, or go down the path of Part C, which is Medicare Advantage.

Just remember that when it comes to signing up for Medicare at 65, if you are going to continue working, you don’t necessarily have to sign up if you have credible coverage that you want to keep from your employer of over 20 employees. I know it’s clear as mud.

Another great resource for investigating this further is the Medicare & You guide, which you can pick up or download on the website. It’s called the Medicare & You Handbook and has all the details. If you’d like a copy, I’d be more than happy to send you an email with that link.