Working Past 65: Here's How Medicare Fits In
Author: Senior Medicare Patrol
Working Past 65: Here's How Medicare Fits In
Senior Medicare Patrol
Many adults choose to work past age 65, or are covered by a spouse's employer insurance, which raises important questions about how Medicare works alongside group health plans. The good news is you have options and understanding them can help you avoid gaps in: coverage or costly late penalties.
If you’re still working and have health coverage through your job or your spouse's job, you may be able to delay Medicare. Part B and Part D without penalty. The key factors are employer size and whether the group health plan is considered creditable coverage.
Employer Size Matters:
The number of employees at your or your spouse's workplace plays a big role in how Medicare coordinates with that insurance.
• 20 or more employees:
The group plan pays. first, and Medicare is secondary. You can delay enrolling in Medicare Part B and Part D without penalty, as long as you remain covered
* Fewer than 20 employees:
Medicare becomes your primary insurance. You (or your spouse) should enroll in Medicare Parts A and B when first eligible to avoid coverage gaps and late penalties.
Covered Through Your Spouse's Job?
If you’re 65 or older and covered under your spouse’s employer insurance, the same rules apply based on the employer's size. You can usually delay Medicare Part B without a penalty as long as the employer plan is considered primary and creditable.
However, once your spouse retires or loses that Coverage, you must enroll in Medicare during the Special Enrollment Period (within 8 months) to avoid a late enrollment penalty. It's also wise to compare coverage; sometimes Medicare offers better benefits or lower out-of-pocket costs.
What: About Medicare Part A?
Most people get Part A premium-free. If you’re eligible, enrolling in Part A while still working on a spouse’s plan can help with hospital-related expenses, but don't enroll in Part A if you want to keep contributing to a Health Savings Account (HSA) as Medicare enrollment disqualifies you from HSA contributions.
When Employer Coverage Ends
If your (or your spouse's) group health coverage ends, you’ll enter a Special Enrollment Period and have up to 8 months to enroll in Part B without a penalty. This is a great time to consider adding prescription drug coverage Part D F or supplemental insurance.
The time of transition from employer coverage to Medicare can be challenging to navigate. It is also a time when fraud can occur as a beneficiary is shopping for coverage.
Need Help?
Medicare decisions can be complex, especially when employer coverage or a spouse’s plan is involved. SHIP counselors and Senior Medicare Patrol (SMP) are located at Area Agencies on Aging (RMDC) across Montana to assist with Medicare questions and concerns. If you think you have experienced potential Medicare Fraud, errors or abuse, contact your local Senior Medicare Patrol!
Call us at 1-800-551-3191
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