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Medicare Coverage and Employment


Whether they’re concerned with affording retirement or love their job, Americans are working later in life. In fact, the percentage of older adults working today is the largest since the creation of Medicare in the 1960s.

Some individuals, maybe even you, will still be actively employed upon becoming eligible for Medicare. Can you enroll in Medicare while you’re still in the work force, and if not, will you get a penalty?

Can You Have Medicare While Working?

If you’re working when you enter your Initial Enrollment Period (IEP), you can enroll in Medicare. As long as you meet all the criteria needed to be eligible, it is your right to do so. You can also choose to delay your Medicare coverage, though you may be penalized later.

If you don’t receive health coverage through work, it’s safe to say you should get Medicare coverage.

What If I Have Non-Retiree Health Coverage Through My Employer?

If you have non-retiree health insurance through your or your spouse’s employer when you become eligible, you’ll have to choose if you want to enroll in Medicare Parts A, B, and/or D. (for information about each part visit https://keystoneelderlaw.com/4216/). Ultimately, this decision depends on the type of health coverage you or your spouse currently have and the size of your or your spouse’s employer.

If the employer has fewer than 20 employees, you’ll probably want to enroll in Parts A, B, and D upon becoming eligible for them. In this situation, Medicare usually becomes your primary coverage. If the employer has 20 employees or more, you may want to delay Parts A, B, and/or D if you have sufficient group coverage and know you won’t incur late enrollment penalties. Medicare usually pays second to group coverage from larger employers.

Generally speaking, you should probably enroll in Part A after qualifying for Medicare. For many seniors, Part A is premium-free and acts as great supplementary coverage. In some cases, it may not make sense to enroll in and pay the monthly premiums that come with Parts B and D right away. Before making the decision to delay any part of Medicare, compare the coverage to see if enrolling in it while covered by your current health plan makes sense. If you have any questions, you can always reach out to a licensed agent.

When Can I Delay Medicare Without a Penalty?

If you have non-retiree group coverage through your employer or your spouse’s employer, you will most likely be able to delay Medicare Parts A, B, and/or D without getting penalized. You could be at risk for receiving late enrollment penalties if:

  • If the company you or your spouse works for has under 20 employees and you delay your Medicare coverage
  • If you get qualifying coverage through your domestic partner’s workplace, but aren’t married to him or her, and delay your Medicare coverage
  • If your employer does not offer creditable prescription drug coverage and/or you go at least 63 days without creditable drug coverage

What Should I Do After I Retire?

Once your employment or non-retiree employee group coverage ends (whichever comes first), you’ll enter a Special Enrollment Period (SEP). During this SEP, which starts the month after the qualifying event and lasts for the eight months afterwards, you can usually enroll in Parts A and B without incurring a penalty.

If you don’t enroll in Parts A and/or B during the SEP, you’ll start to accrue a penalty that’ll take effect if and when you enroll in them.

Remaining on your or your partner’s employee health plan after age 65 may seem like a good choice, but that’s not always the case. Knowing your options can keep you covered when you need it most. Whether you’re remaining on an employee health plan and doubling up with a Medicare plan or going right to Medicare coverage, you can explore your options with the Medicareful Plan Finder. With this tool, you can search for Medicare plans in your area, directly compare costs and coverages, and connect with a licensed insurance agent if you have questions!

Contributing author: AIA Alera Group