Medicare While Still Working

When you turn 65 years old, you are eligible for Medicare whether or not you are employed, if you like your employer’s coverage you can defer signing up for Medicare when you officially retire. However, if you decline or postpone signing up for Medicare, you’ll pay a penalty if you eventually sign up for coverage.

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Getting Medicare while you’re still working depends on the size of your employer, or how many employees they have. More and more seniors are working past the age of 65 and the rules of if you need Medicare or not can be confusing.  The answer is, it depends, keep reading for the answer to your specific situation or call 844-528-8688 for a personal consultation.

Medicare while still working – Your company sets the rules

There are a couple of facts you need to know about signing up for Medicare if you are going to work past age 65 and your Medicare Open Enrollment period.  The size of your employer will determine if you must sign up for Medicare or if you will be able to put it on hold.  See the list below to see what situation fits you.

• The employer has Less than 20 employees:  If this is your situation, you should sign up for Medicare Parts A and B as soon as you are eligible.  In this situation, Medicare works with your group plan if you have one and will be the primary provider.
  •    If you refuse to sign up with Medicare your group plan can refuse payment on your claims, and you will end up with a fine for late enrollment to Medicare.
• The employer has 20 or more employees:  If you have a group health insurance plan, you may be able to delay or put on hold both Medicare Part A and Part B.
  • If you are eligible for Part A, with no premium you can enroll and put Part B (which has a premium) on hold until you retire or lose group coverage.

Compare The Costs

If you are working for a larger employer or getting your benefits from a spouse and are entering your Medicare Open Enrollment, you will want to compare the costs and benefits.

With Medicare and a Medicare Supplement Plan your coverage might be much better than what you currently have through your employer.  Many employers or group plans have gone to high deductible or HSA model plans.

You should carefully look at what your group plan costs in premium and compare that to Medicare and a supplemental plan.

Medicare and Retiree Plans

If you are getting a retiree plan from your previous employer, you should sign up for parts A and B.  You might not need a Medicare Supplement plan in this instance because Medicare would pay primary to your plan.

You still will want to look over the cost of any retirement plan verse a Medigap plan.  You will pay for your Part B premium in this scenario.

Medicare and COBRA

Cobra would be the same as the retiree plan and you would need to start Part A and B and they would pay primary to the COBRA plan.  The COBRA coverage will only last eighteen months or a year and a half.

Signing up for Medicare while still working

The process for signing up for Medicare while you are still working is the same.  Your enrollment period starts three (3) months before you turn 65, the month you turn 65, and extends three months past your 65th birthday month.

1. You can call Social Security 800-772-1213
2. Apply online:  https://www.ssa.gov/benefits/medicare/
3. Visit your local Social Security Office:  Click for Office Locator

The Benefits of Getting Medicare While Working

Your hospital coverage in Medicare is offered through Medicare Part A. The services covered under Part A include:

• inpatient hospital services
• hospice services
• home healthcare (limited)
• skilled nursing facility services (limited)
• inpatient mental health care
• inpatient rehabilitation services

If you qualify for zero-premium Medicare Part A, enrolling in Part A while still working is generally a good idea.

What about Medicare Part B?

Medicare Part B provides out-patient coverage for services like:

• doctor and specialist visits
• labs, blood work, and urinalysis
• physical therapy 
• imaging and echocariograms
• outpatient mental health care
• Medicare approved vaccinations

If you or your spouse is working at the time you are eligible for Medicare Part B, this provides for an 8-month special enrollment period. During this special enrollment period, individuals can keep their employer group plan for as long as it is offered. If an individual leaves an employer, or if the employer terminates coverage, they will typically have 8 months to enroll in Medicare and not be subject to a late enrollment penalty.

Cost and Benefits

At the end of the day, you will need to determine what is the most cost-effective plan for your health and Medicare benefits.  If you are looking at Medicare While Still Working, reach out to your benefits coordinator or Human Resource person to have a discussion.

Remember that if you are keeping your group plan and Medicare Parts A and B, you will most likely have a premium for the plan and part B.  It is very important to calculate the costs and benefits especially if you are on a spouse’s plan.

Frequently Asked Questions

You can always call us for information regarding the Medicare side of the equation at 844-528-8688 or email us from our Contact Us Page.

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