One of the most common questions we get at the Medicare Coach is, “I will be working when I turn 65. Do I have to join Medicare?”
This is an excellent question because more and more people are working after they turn 65, and they are either covered under their employer insurance or their spouses.
As you likely know, when you turn 64, you start getting bombarded with phone calls and mailers from insurance companies selling certain Medicare products.
You are made to believe that you HAVE to join Medicare, or you could face hefty penalties. With so much conflicting Medicare information out there, you may not be getting clear answers on what to do.
Here is the thing, if you have health insurance through your employer or your spouses when you turn 65, you can likely delay joining Medicare without penalities.
In this email, I want to share the three things you need to know to delay Medicare and if you should.
1) Your current coverage must be deemed creditable by Medicare standards.
The Medicare rule states: “By the time you turn 65, you either need to be on Medicare or be covered under an acceptable health insurance plan. If you don’t meet these rules, you will face penalties.”
There are three requirements your current plan must meet:
- They don’t require you to join any parts of Medicare.
- They must have 20 or more employees. (100 or more if you’re disabled)
- Your prescription coverage is as good or better than Medicare.
If it meets these three requirements, your plan is considered “creditable.”
2) Medicare may be less expensive than your current coverage.
Just because your current insurance is “creditable” doesn’t mean that it’s the most affordable option. At times, we have seen that Medicare can provide the same coverage at less cost to our clients.
When comparing your current employer insurance to Medicare, I recommend comparing the premiums, deductibles, co-pays, and anything that has a cost.
I typically advise that if your employer plan has monthly premiums of more than $250 per person and has an annual maximum out-of-pocket expense of $2,000 or more, it may be more cost-effective to join Medicare.
3) If your current insurance covers other family members, Medicare will only cover you.
If your current insurance covers you, your spouse and/or your children. It’s important to remember that joining Medicare means you will have to find health coverage for them if they are under 65.
With these three things said, I have seen instances where people join Medicare to be safe. That means they enrolled in Medicare to make sure they didn’t face those penalties, but they ended up overpaying for health insurance when they didn’t have to.
I don’t want you to make that same mistake.
You must look at your current insurance, and if it is credible and cost-effective for your situation, you can likely delay Medicare without penalties.
You can talk to the department at your work who handles the health insurance, and they will be able to tell you if their plan is creditable or if they require you to join any parts of Medicare.
Please note that if you’re on a retiree plan, a Federal plan, or a Veteran plan, it is a bit messier, so be sure you understand what those plans require of you as well.
If you’re going to be covered by employer insurance after you turn 65, we have created an easy to follow guide to give you the exact steps to help you determine if you can delay your Medicare decision. This guide is called “Delaying Medicare Without Penalties.” It is a great resource to save you time and money and give you peace of mind that you are taking the right Medicare steps.
To get “Delaying Medicare Without Penalties,” CLICK HERE.
