Over 65 and Working? Here are Four Common Medicare Questions

Steven Mott by Steven Mott | Licensed since 2012
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This article was updated on: 11/21/2018

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The Bureau of Labor Statistics projects that Americans over 65 will be the fastest-growing age group in the workforce between 2014 and 2024. But what about Medicare eligibility when you’re over 65 and working? We’ll explore some common questions and give you straight answers.

How does Medicare work if you’re over 65 and working?

If you’re eligible for Medicare, it doesn’t really matter if you’re still working. Even if you have employer-based health insurance, you’re still entitled to Medicare. Your plan and Medicare may have to coordinate benefits.

Here’s all you generally need to be eligible for Medicare:

  • Be 65 or older, or qualify by disability.
  • Be a United States citizen, or permanent legal resident of at least 5 years in a row.

It’s important to understand how Medicare works with your other health insurance, and whether you should delay enrollment in Medicare Part B.

Can you get Medicare if you already have health insurance?

If you’re over 65 and still working, you might have group health insurance through work or a union. You might even have insurance through the federal health insurance marketplace under the Affordable Care Act.

How does Medicare work if you’ve already got health insurance? You might not be automatically enrolled in Medicare – but you can still get it, assuming you’re eligible. Many people are automatically enrolled in Original Medicare (Part A and Part B) if they’re getting Social Security Administration (SSA) benefits when they qualify for Medicare.

But some people decide not to start getting Social Security benefits right away. Your SSA benefits may be higher if you start collecting benefits later, up until age 70.

Suppose you decide to postpone your SSA benefits until you’re 70. When you turn 65, you’re eligible for Medicare.

In this case:

  • You won’t typically be enrolled in Medicare automatically – because you’re not yet receiving SSA benefits. You can still sign up for Medicare. More on that later.
  • Before you sign up for Medicare, talk to your benefits administrator at work, or your health insurance company. Ask how enrolling in Medicare will affect your current health insurance.

You can generally keep your group health insurance if you’re still working past age 65. Make sure each type of health insurance provider knows about the other. That is, tell your group health insurance company before you sign up for Medicare. On your Medicare application, give the name of your health insurance company and other information as requested.

Should you delay Medicare Part A and Part B enrollment?

If you’re over age 65 and still working, you may be eligible for Original Medicare (Part A and Part B) – but should you delay enrollment?

You might want to sign up for Medicare Part A (hospital insurance). If you’ve worked for at least 10 years while paying Medicare taxes, you won’t have to pay a Part A premium. If you don’t qualify for premium-free Part A, you might face a late enrollment penalty if you delay enrollment.

When it comes to Medicare Part B, this might be a harder decision. In most cases, you’ll pay a Part B monthly premium. Since Part B is medical insurance, and your employment-based group plan is also medical insurance, do you really need both?

As mentioned above, you should talk to your benefits administrator at work before deciding whether to delay enrollment in Part A or Part B.

If you decide to delay Part B enrollment, it’s important to know that there’s a late enrollment penalty. You can generally avoid the penalty if you enroll when your employer-based coverage is ending. Read more about Medicare penalties for late enrollment.

How do you sign up if you’re over 65?

Sign up for Medicare through the Social Security Administration (SSA).

  • Visit https://www.ssa.gov/benefits/medicare/ .
  • Go to your local Social Security office.
  • Call the SSA at 1-800-772-1213. TTY users can call 1-800-325-0778. Representatives are available Monday through Friday, from 7AM to 7PM.

If you work(ed) for a railroad, you might need to sign up through the Railroad Retirement Board (RRB). Their website is https://rrb.gov/Benefits/Medicare/RB20.

What else should I know about Medicare when I’m over 65 and working?

One more decision you might have is whether to delay enrollment in Medicare prescription drug coverage under Medicare Part D.

  • This coverage is optional.
  • If you don’t sign up when first eligible, you might face a Part D penalty if you sign up later on.
  • You probably won’t pay a Part D penalty if you have prescription drug coverage through your employer that’s considered “creditable,” and if you sign up for Part D coverage promptly when your employer coverage ends.

Read more about the Medicare Part D late enrollment penalty.

To compare Medicare coverage options, you can start exploring by clicking the Find Plans button on this page. You can also use the links below to have me send you a personalized email or to set up a time to talk.

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