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Do you need Medicare if you have employer coverage?

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If you are turning 65 or already over age 65 and receive health insurance coverage from your employer and do not need Medicare coverage, you still need to take several important steps to avoid incurring a penalty when you enroll in Medicare. Not taking the right steps on time could lead to unpleasant surprises like lifetime penalties, periods without health coverage, and even insurance claim issues.

The necessary steps depend on your age, if you have a qualifying disability, or if you have retiree or COBRA coverage. Your requirements for enrolling in a Medicare plan at age 65 may also be impacted by the size of your employer and the plans available through your employer.


Turning 65 and Still Working

If you are turning 65 years old and still working, you may want to ask your employer or union benefits administrator if they require you to enroll in Medicare.  If your employer does not require you to sign up for Medicare right away, be sure to sign up during your special enrollment period to avoid a late enrollment penalty.

Your Turning 65 Checklist

Working Past Age 65

If you are over the age of 65 and you are still working, you do not need to do anything until you retire.  After you or your spouse decide to retire, you’ll be able to enroll in Medicare during a special enrollment period without incurring a late enrollment penalty.

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Under 65 with a Disability

If you are under 65 years of age and have a disability, you will want to ask your employer or union benefits administrator if they require you to apply for Medicare if the following applies:

  • You, your spouse, or family member are working
  • You’re covered by an employer or union group health plan (with at least 100 employees) based on that employment

If your employer does not require you to sign up for Medicare right away, you may sign up during a special enrollment period without incurring a late enrollment penalty.

COBRA or Retiree Health Insurance

In the instance that you have COBRA or retiree health insurance from a former employer or union, Medicare will become the primary health insurance after you enroll. Any amount not covered by Medicare can be submitted to your employer’s plan for secondary coverage.

Check My Eligibility

Some conditions may apply if you do not sign up for Medicare when you are first eligible. If you do not sign up for Medicare when you are eligible, your current health plan coverage may not pay your medical costs. You may also need to have Part A and Part B to get full benefits from this coverage. When your current coverage ends, you may not be eligible to enroll in Medicare through a special enrollment period.

If you have any questions or concerns about your employer coverage and how it could impact your future enrollment in Medicare, contact a trusted advisor like our team at RetireMed.

Call: 937.915.3563

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