More and more people are working past the age of 65. This is especially true now that people turning 65 this year must wait until they are 66 years old to collect full retirement benefits from Social Security.
Whether or not you continue to work, you can still get Medicare when you turn 65, and you still need to make some important decisions about enrollment. You should start to think about these decisions at least 3 months before your 65th birthday.
This section looks at some of these enrollment questions. If you already have Medicare, scroll to the bottom of the page for information about how Medicare works with your employer coverage.
Do I need to take Medicare now?
If you are still working after you turn 65 (or your spouse is still working) for a company with 20 full-time workers AND you get health insurance from them, you may not need all of Medicare when you turn 65. You can delay certain parts of Medicare, and get them later on when you retire, or if you lose your job-related insurance.
- Learn more about Medicare Part D prescription drug coverage and why you need to know whether you have “creditable drug coverage.”
Most people should enroll in Medicare Part A when they turn 65, even if they have employer health insurance. This is because it is free for most people who are eligible for Medicare. Why is it free? We pay for Medicare Part A through payroll deductions while we work. If you have insurance through a job, Medicare Part A may not pay much toward your health care costs because Part A generally pays after (called secondary) your job's insurance. By taking Medicare Part A when you first become eligible for it you will not need to worry about enrolling later.
Note: If you get insurance from your job (or your spouse's job), be sure and talk with them first. See how your job's insurance may change when you get Medicare, even Medicare Part A.
Who should not enroll in Part A when they turn 65?
Some people have a kind of health insurance through their work called a Health Savings Account (HSA). If you have an HSA, you may not want Medicare Part A right away; you may be the exception to the rule and need to delay Medicare Part A if you have a HSA through your job. That's because an employer may stop contributing to your HSA account once you enroll in Part A. It is really important for you to speak with your job's human resource department to see how Medicare may change your benefits.
What if I work for a small company or am self-employed?
If you work for a small company (less than 20 employees) or are self-employed, you will probably need to take Medicare Part B in addition to Part A when you turn 65.
Note: If you are buying insurance through the Health Insurance Marketplaces, you will no longer be eligible for a subsidy to help pay your insurance premium once you become eligible for Medicare.
How do I apply?
To apply for Medicare, you must contact Social Security at 1-800-772-1213, or visit them online. Once you enroll, your Medicare card and “Welcome to Medicare” kit will come in the mail.
Aon Hewitt Navigators® is a Medicare insurance brokerage service recommended by NCOA because it meets rigorous Standards of Excellence established by NCOA. You may be eligible for personal one-on-one assistance in selecting and enrolling in health coverage. All of the services are provided at no cost to consumers. Check to see if you are eligible.
I have Medicare. How does it work with my employer insurance?
If you have Medicare and other health insurance or coverage, each type of coverage is called a “payer.” When there's more than one payer, “coordination of benefits” rules decide which one pays first. The “primary payer” pays what it owes on your bills first, and then sends the rest to the “secondary payer” to pay. In some cases, there may also be a third payer.
The official Medicare publication Who Pays First? can help you understand whether your employer coverage is the primary or secondary payer to Medicare.