Can I Enroll in Medicare at 65 If I Am Still Working?
Medicare is a form of government-provided medical insurance available to beneficiaries over the age of 65, as well as some younger beneficiaries with qualifying medical conditions.
As you approach age 65, you might be looking forward to the affordable healthcare options that Medicare provides. However, if you’re still working and have employer-provided insurance, you might also feel a little unsure.
At Senior Insurance Agency, we’re here to clear up this confusion and help you better understand your insurance options at this stage of life. Let’s take a look at how Medicare enrollment works while you’re still employed.
Table of Content
1. Understanding Eligibility for Medicare at 65
2. Your Health Coverage Options While Still Employed
3. Key Factors to Consider During Your Decision
4. Special Enrollment Periods (SEPs)
5. Steps to Take If You Decide to Enroll in Medicare
6. Explore Medicare Options with Senior Insurance Agency
Understanding Eligibility for Medicare at 65
For most people, Medicare eligibility starts at age 65, regardless of employment status. Some beneficiaries can access Medicare coverage earlier in life through disability benefits, or through certain qualifying conditions like end-stage renal disease.
Medicare consists of several different components, which are provided by both the Centers for Medicare and Medicaid and private insurance companies. These include:
- Part A (hospital insurance): This covers inpatient hospital stays and skilled nursing care. Most people do not pay a monthly premium for Part A.
- Part B (medical insurance): This covers outpatient medical services such as exams, testing, vaccines, outpatient treatment, and medical equipment. Part A and Part B combine to form Original Medicare.
- Part C (Medicare Advantage): Part C is a form of Medicare provided by private health insurance companies that are funded by Medicare, rather than the federal government. Among all Medicare beneficiaries, 47% enroll in a Medicare Advantage plan, while 53% use traditional Medicare, according to KFF.
- Part D (drug coverage): Part D plans are offered by private insurance companies and cover prescription drug costs. Beneficiaries can purchase Part D plans in addition to Original Medicare or have it combined in their Part C plan.
Medicare supplement (Medigap): Medicare supplement plans are optional plans offered by private insurance providers and cover some of the out-of-pocket costs associated with Original Medicare. These include things like copays, co-insurance, and deductibles.
Your Health Coverage Options While Still Employed
If you reach age 65 and are still working, you have a few options when it comes to health insurance.
Option 1: Staying on Employer-Sponsored Health Insurance
The first option is to remain on the group health plan provided by your employer. Many companies offer some form of health insurance as a benefit for those who are still actively working.
Some people opt to maintain their employer-provided health insurance coverage past the age of 65 because of the unique benefits their plan offers, or because their healthcare providers do not accept Medicare. In some cases, an employer-provided plan may also have cheaper monthly premiums than a comparable Medicare plan.
Combining Employer Insurance and Medicare
It’s also important to note that you can have both employer-sponsored insurance and Medicare at 65+. According to Census.gov, approximately 40% of adults over the age of 65 have dual coverage.
One plan will be your primary plan, while the other will be your secondary plan. However, this approach depends on the size of the company you work for.
If your employer has more than 20 employees, you will have the flexibility to choose whether you want to remain on their healthcare plan, switch to Medicare, or use both plans. Your employer-provided plan will be considered your primary coverage.
However, if you work for a company with less than 20 employees, your Medicare coverage will be primary to your employer sponsored plan. However, you are not required to go onto Medicare unless your employer plan requires you to.
Most people opt to enroll in Part A while still working, but delay Part B enrollment until retirement and keep their employer-provided coverage for medical services. Part A is available premium-free for most people through the Social Security Administration.
There are a few reasons why someone might do this:
- The monthly premiums for Ppart B coverage are higher than the cost of your employer-provided insurance.
- You have dependents that are reliant on your employer-sponsored health insurance.
Option 2: Enrolling in Medicare
You can enroll in Medicare once you turn 65, even if you are still working. However, you can choose which type of Medicare plan works for you depending on your healthcare needs and budget.
Here’s how to enroll in Medicare at 65. The initial enrollment period for Original Medicare starts three months before you turn 65, the month that you turn 65, and three months after.
Learn Your Medicare Eligibility Today
Key Factors to Consider During Your Decision
Deciding how to approach Medicare isn’t an easy decision, especially while you’re still working. Here are some things to keep in mind.
Cost Comparison
The first thing to consider is the out-of-pocket costs you’ll pay with each option. Consider factors like monthly premiums, deductibles, and copays.
Medical costs look different for everyone, depending on your health needs and care preferences. For example, a Medicare Part B plan may have higher monthly premiums than your current employer-provided plan, but could save money in the long run by giving you access to a wider range of healthcare providers.
It’s also important to note that delaying Part B coverage will not come with any penalties as long as you are actively working and receiving employer sponsored health insurance.
Coverage Needs
Another factor to consider is the specific type of coverage you need given your current health status. For example, you might want to stick with a specific provider, in which case you’ll need to make sure they accept your healthcare plan.
Some people also opt to stay on their employer-provided healthcare plan due to additional wellness benefits that aren’t available through Original Medicare. For example, your employer may provide good dental coverage, which Original Medicare doesn’t provide.
Special Enrollment Periods (SEPs)
If you want to delay Medicare enrollment and stay on your employer-provided insurance, you can use a special enrollment period to sign up later when you retire or drop your employer coverage.
Using these enrollment periods will help you avoid financial penalties for delaying coverage. You’ll need to submit proper paperwork to the Social Security Administration to prove that you qualify for this exemption. If you opt for a late-enrollment Part D plan, you’ll also need to submit paperwork to your prescription drug company.
Enroll in Medicare While Employed
Steps to Take If You Decide to Enroll in Medicare
If you want to enroll in Medicare while still employed, you can do so by signing up online through the Social Security Administration. If you’re still working and haven’t claimed retirement benefits yet, you won’t be automatically enrolled when you turn 65.
Instead, you’ll need to sign up during one of the designated enrollment periods. The online form will show you how to sign up for Medicare at age 65 and walk you through the process.
If you only want to enroll in Part A for the time being, select “no” to Part B when filling out the online forms.
Working with a trusted insurance agent makes this process easier. An agent will help you compare your options and ensure you don’t miss any important enrollment deadlines.
Explore Medicare Options with Senior Insurance Agency
If you’re working past 65, Medicare is available to you, even if you don’t plan to retire anytime soon. Working with a senior insurance agent can help you navigate the complex enrollment process and understand available coverage options.
Whether you want to remain on your employer-sponsored plan, sign up for Medicare, or use a combination of both, Senior Insurance Agency is here to help. We offer support for Medicare in Carson City and throughout the state of Nevada.
Contact Senior Insurance Agency for personalized guidance. You’ll need to review the Medicare scope of appointment rules and fill out the form before your consultation.