Understanding Medicare enrollment can be confusing, especially if you have health insurance through your employer. When you turn 65, you may become eligible for Medicare, but deciding whether to enroll depends on various factors, such as your employer’s size and current coverage. Having a clear understanding of the rules can help you avoid penalties and ensure that you have the coverage you need. Here’s a guide to help you decide whether to enroll in Medicare at 65 if you have employer health insurance.

Should You Sign Up for Medicare at 65 if You Have Employer Insurance?

What Are the Rules for Medicare Enrollment with Employer Insurance?

  • Employer Size Matters: If your employer has 20 or more employees, your employer insurance will typically be the primary payer, and Medicare can act as the secondary payer. You can delay enrolling in Medicare Part B without incurring penalties. However, if your employer has fewer than 20 employees, Medicare becomes the primary payer, and your employer insurance is secondary, making it important to enroll in Medicare Parts A and B at 65 to avoid coverage gaps and penalties.

What Are the Costs and Benefits of Delaying Medicare?

  • Medicare Part A: If you qualify for premium-free Part A, enrolling as soon as you’re eligible is a good idea. It won’t cost you anything and ensures you avoid penalties later.
  • Medicare Part B: Since Part B has a monthly premium, you might consider delaying it if your employer insurance provides sufficient coverage. Ensure your employer coverage is considered “creditable” to avoid future penalties. If you delay enrollment in Part B, you might face a late enrollment penalty of 10% of the premium for each 12-month period that you could have had Part B but didn’t sign up for.

How Do You Compare Costs and Coverage?

  • Evaluate Your Current Plan: Compare your employer plan’s benefits and costs (premiums, deductibles, co-pays) with those of Medicare. This comparison will help you determine if enrolling in Medicare makes financial sense.
  • Coordination of Benefits: Understand how your employer plan coordinates with Medicare. Some employer plans may require you to enroll in Medicare once eligible to maintain full benefits.

What Happens If You Delay Medicare Enrollment?

  • Special Enrollment Period (SEP): If you delay Medicare because of employer coverage, you can enroll without penalties during a Special Enrollment Period, which lasts for eight months after your employment or coverage ends.
  • Avoiding Penalties: Continuous creditable coverage is crucial to avoid late enrollment penalties:
    • Medicare Part B: The penalty is 10% of the standard Part B premium for each full 12-month period you could have had Part B but didn’t enroll. This penalty is permanent and will be added to your monthly premium for as long as you have Part B.
    • Medicare Part D: If you delay signing up for Medicare Part D (prescription drug coverage) and your private health insurance doesn’t meet Medicare’s creditable coverage standards, you might pay a penalty. The penalty is 1% of the “national base beneficiary premium times the number of full, uncovered months you didn’t have Part D or other creditable coverage. This amount is added to your monthly Part D premium.

How Can Skyline Benefit Help?

What is Skyline Benefit?

  • Expert Guidance: Firstly, Skyline Benefit is an independent Medicare insurance agency with licensed professionals who help individuals understand their health plan options and enroll in Medicare. Furthermore, our agents offer policies from multiple carriers, providing a broad range of options

Why Choose Skyline Benefit?

  • Access to Multiple Carriers: Skyline Benefit offers plans from various providers, increasing the likelihood of finding a plan that fits your needs.
  • Impartial Advice: Additionally, we provide unbiased information, helping you make informed decisions without pressure.
  • Time-Saving: Moreover, Skyline Benefit agents can quickly provide quotes from different carriers, saving you time and effort.
  • Personalized Service: Our agents offer personalized guidance, ensuring you understand your options and choose the best plan for your situation.


Deciding whether to enroll in Medicare at 65 when you have employer insurance involves understanding the rules, evaluating your current coverage, and possibly consulting with an independent Medicare insurance agent like us at Skyline Benefit. This ensures you make the best decision for your health and financial well-being.

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

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