If you reach 65 and still have health coverage, will you need to sign up for Medicare? Many people have these same questions, and Medicare’s many enrollment periods are there to accommodate all cases. The important thing is to enroll on time, or you will face a late-enrollment penalty applied to your monthly premiums.
Special Enrollment Periods
Special Enrollment Periods (SEP) are open only for specific and unavoidable circumstances. These circumstances can include:
- Moving out of your plan’s service area
- Losing your current plan’s coverage, or your coverage with Medicare has changed
- Applying for different coverage now, but applying for Medicare later when you no longer receive that coverage
If you are still working at 65 and receiving health coverage through your employer, you may qualify for a Special Enrollment Period, provided your employer has at least 20 employees. You will not receive a late penalty if you enroll for Medicare during this period.
The Special Enrollment Period following the loss of employment group health plan coverage lasts for eight months. In the case of health coverage through an employer, the Special Enrollment period will begin once you no longer have the coverage or employment ends, whichever occurs first.
Coverage Through Employment
Even if you decide to delay enrollment in Part B, it could be beneficial to sign up for Medicare Part A. Because most people receive premium-free Part A, you can have peace of mind with hospital insurance in case of an emergency. Premium-free Part A goes to people who have paid or whose spouse has paid payroll taxes to Social Security for at least forty quarters. To sign up for Part A, contact your local Social Security office once you become eligible for Medicare or fill out the forms online at medicare.gov.
How Does the Coverage Work Together?
Those who sign up for Medicare during their Initial Enrollment Period instead of waiting to lose the coverage when employment ends can hold both Medicare and their group health plan. The group health plan will pay first in most cases, and if the bill is not fully covered the provider can send the bill to Medicare for the remainder. Medicare pays based on the group health plan’s payment, coverage, and the charge billed by the healthcare provider.
