If you have group health insurance through your or your spouse’s employer, you may wonder whether you need to apply for Medicare. The answer is it depends.
In most cases, if you are 65 or older and have group health insurance through your or your spouse’s employer, you can delay enrolling in Medicare without penalty, depending on the size of your employer, you can delay enrolling in Medicare. The same goes for your health insurance if it’s through your spouse’s job. However, you need to consider some rules about enrollment. This is because group health insurance is considered creditable coverage, meaning it provides at least as much coverage as Medicare. You can delay enrolling in Medicare without penalty if you have creditable coverage.
When can I Enroll for Medicare if I work for a Large Company?
You can choose to sign up for Medicare Part A when you turn 65 or anytime later, even with employer coverage. It’s premium-free as long as you or your spouse have paid at least 40 quarters of Medicare taxes.
For Medicare Part B, you can choose to wait until you or your spouse stop working or lose your health insurance to avoid paying premiums for both Medicare and employer coverage. In 2024, Medicare Part B is $174.70, which is $9.80 more than the 2023 premium of $164.90. However, an individual’s income-related monthly adjustment amount (IRMAA) could increase the Medicare Part B premium by as much as $594.
Once you stop working or lose your health insurance, you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare or add Part B to existing Part A coverage. The SEP starts when you stop working or lose insurance.
Do I need to enroll for Medicare if I work for a Small Company?
If you work for an employer with less than 20 employees and are 65 years or older, you may need to enroll in Medicare when you become eligible. The eligibility begins three months before and ends three months after the month you turn 65. It is important to note that Medicare is considered the primary payer for individuals over 65 years of age working for small employers. In such a case, you must enroll in Medicare Part A and Part B when you become eligible to avoid any penalties.
Medicare Eligibility for Individuals with Disabilities
It’s important to note that if you are eligible for Medicare because of a disability, you may need to enroll in Medicare even if you have group health insurance through your or your spouse’s employer. This is because group health insurance is not considered creditable coverage for individuals eligible for Medicare because of a disability.
Do I Need to Apply for Medicare if I have COBRA coverage?
Suppose your previous employer offered you COBRA coverage after your employment ended or after you lost coverage as a dependent of the covered employee. In that case, there are a few things you need to keep in mind.
First and foremost, you must sign up for Medicare once you turn 65 to avoid any gaps in coverage and a monthly Part B late enrollment penalty. Your COBRA coverage will likely end once you’ve successfully enrolled in Medicare.
How do I sign up for Medicare when I am ready?
Before you sign up:
- If your employer coverage is ending, sign up for Medicare about a month before your current coverage ends to avoid a coverage gap.
- Applying online at Social Security is the easiest and fastest way to sign up and get any financial help you qualify for.
- You’ll create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online.
Wrapping up
Deciding when to enroll in Medicare can be complex and confusing, especially if you have group health insurance through your or your spouse’s employer. However, it’s crucial to understand the rules and regulations surrounding enrollment so that you can make informed decisions about your healthcare coverage. Remember, if you have any questions or concerns about Medicare enrollment, you can contact our Skyline Benefit expertise or the Social Security Administration for assistance. With the right information and support, you can easily navigate the Medicare enrollment process and enjoy the peace of mind that comes with comprehensive healthcare coverage.
Do you need a consultation for Medicare in 2024?
Skyline Benefit is an independent Medicare insurance broker that offers affordable and flexible Medicare options. Selecting the best Medicare insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112