Medicare Marti

65th birthday party medicare eligible

Are There Exceptions to Starting Medicare at 65?

The importance of having your Medicare in place as soon as you are eligible cannot be overstated. Many, however, continue working past their 65th birthday and may not need Medicare yet as they are still covered by their employer sponsored healthcare plan. 

The answer depends on your specific needs and situation. You need to weigh the options of your employer or retirement plan against the options offered by Medicare to make an informed decision.  

If you are getting coverage from an employer, you should still enroll in Part A. Why? Well, because you previously paid for it and don’t have to pay any more for having it. 

So, in general, you should sign up regardless of whether or not you currently need it or not. (Keep in mind that you may not need to sign up for Part B.) If you have “credible coverage” (healthcare coverage deemed by Medicare to be as good as Medicare (your employer can provide that information), you would be paying not just for your employer sponsored healthcare plan, but you’d also be paying the premium for Part B. In other words, you’d be paying for coverage from two plans when you only need one.  

Here’s an example to illustrate the value of weighing your options: 

I recently spoke with a couple. The husband is retiring soon. The wife elected to take Part B several years earlier; so, she had been paying that premium monthly over those years. However, she was still on her husband’s health plan for which they’d been paying for many years. She did not realize that she could have either delayed her Part B, because she had coverage through her husband’s employer sponsored plan. Or she could have gotten off her husband’s plan and elected to go onto Medicare. It is important to discuss your situation with your employer. 

If you are still covered by your employer’s health plan after your sixty-fifth birthday, you should do an in-depth comparison of  your premiums and other costs and benefits, along with the costs and benefits offered with Medicare policies. Do the math.

Surprisingly, Medicare may be more economical. You don’t need to retire to qualify for Medicare coverage. But, if you or your spouse are still working, you might be able to keep the employer’s plan until you need Medicare by delaying your Part B. It can be helpful to have an unbiased party take a look and help wade through those stormy, dark waters. It can be extremely beneficial to have a fresh set of eyes weighing all options for you and walking you through the process.

Having an expert lay out your options and guide you through the process can help you avoid costly mistakes or penalties.

You may like your current employer’s plan and want to stay on that plan until you retire.

I have many clients who, without guidance, did not realize they could delay Part B and ended up staying on their own or their spouse’s employer’s plan while also paying for Medicare. 

Even if you decide to stay on your, or your spouse’s, employer’s plan, you may want to sign up for Medicare Part A as soon as you are eligible, since it is premium free for most beneficiaries.  

If you work past age 65, deciding whether to enroll in Medicare Part B and D or to stay on your employer’s plan depends on the size of your employer. 

This decision also depends on the cost and coverage of your current plan compared to Original Medicare and Prescription Drug Plan (Part D) or a Medicare Advantage plan (Part C).   

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