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Health Insurance Basics

If You’re Working Past Age 65, You Have Medicare Choices

September 05, 2017

As more baby boomers reach age 65, many of them keep working past traditional retirement age. If you’re 65 or older with no plans to leave the workforce soon, you may be wondering if you should sign up for Medicare. The thing is, it depends. Let’s look at some situations and the options.

Still Working at 65: Things to Know About Medicare and Employer Health Insurance

Just as people have a variety of reasons to keep working when they hit 65, they also have a variety of health, insurance and financial factors that affect their choice of getting Medicare while they continue to work.

The first consideration is whether you already have, or are eligible for, other health coverage — such as through a former or current employer or union.

If you don’t have other health coverage, your choice is simpler. Signing up for Medicare as soon as you turn 65, during your Initial Enrollment Period (IEP), makes the most sense.

If you do have an existing health plan, check with your benefits administrator or insurer about how it works with Medicare. Keep in mind: If you decide to drop your existing plan to get Medicare benefits instead, you may not be able to re-enroll in your old plan if you change your mind later. That’s why it’s important to understand all your options before you switch to Medicare.

You Could Apply for Medicare Right Away … or Wait on Some Parts

Knowing when to apply for Medicare if you’re still working is the first step. Many people enroll in Part A as soon as they become eligible for Medicare — even if they have employer coverage. That’s because if you’ve been working and contributing to Social Security for at least 10 years, you won’t have to pay any premiums for Part A. Just be sure to check how getting Part A may impact your current employer plan.

You might be better off waiting to enroll in Part B, though, because you probably will have a monthly payment. The standard Part B monthly payment is $134, but you might pay more or less depending on your income and whether you’re collecting Social Security. The number of employees working at your company also plays a big part in determining when it might be best for you to enroll in Part B.

When Your Employer Has 20 or More Employees

Businesses with a minimum of 20 full-time employees are required to offer current staffers age 65 and older the same group health plan options they offer everyone else. So, if you (or your spouse) are at least 65 and work for such an employer, your choices include:

  1. Keeping your existing group health plan, which may provide more benefits than Medicare, and wait until you retire to enroll in any aspect of Medicare.
  2. Enrolling in Medicare Part A now if it’s premium-free for you, and wait to enroll in Part B until you quit working or your employer no longer offers you coverage. This is a good choice for many people working past age 65.
  3. Enrolling in both Medicare Parts A and B while keeping your current health plan, even though you might have a monthly payment for Part B, as well as your group plan premium (often through payroll deductions).
  4. Declining your employer’s group health plan and enroll in both Medicare Parts A and B. You can also add a prescription drug plan (Part D) and/or a Medicare Supplement plan for even more coverage.
  5. Declining your employer’s group health plan and enroll in a private insurer’s Medicare Advantage Plan, also known as Part C, which might include prescription drug coverage.

Please note: If you decline your employer’s plan, all family members covered by it — including a spouse and/or children — would also lose their group benefits and need to find a new plan. Consider who else might be affected before you quit your current plan. One more thing: Finally, if you choose to wait to enroll in Medicare after age 65 while you continue to work, you will get a Special Enrollment Period (SEP) to sign up when you retire. If you wait beyond your SEP to enroll, you might need to pay a late penalty.

When Your Employer Has Fewer Than 20 Employees

Smaller companies with fewer than 20 full-time employees don’t have to offer health plans to people over 65. If your employer requires you to enroll in Medicare instead of their plan, your choices are:

  1. Enrolling in Medicare Parts A and B, and perhaps add a prescription drug plan (Part D) and/or a Medicare Supplement plan.
  2. Enrolling in a Medicare Advantage Plan (Part C), with or without prescription drug coverage.

Even if your company lets you keep your health plan through them, you may want to consider enrolling in Medicare Part B when you’re first eligible anyway — because Medicare becomes the primary insurer and the employer’s health plan becomes secondary. That means your employer's plan could refuse to pay for services that Medicare would cover — so if you don’t have Medicare, you might have to pay for those services out of your own pocket.

You Don’t Have to Decide All by Yourself

Remember, check with your benefits administrator or insurer if you have existing coverage before you make any decisions about signing up for  Medicare at age 65. You’ll want to carefully review and weigh the benefits of your employer’s group health plan coverage against your Medicare options — and do a cost comparison.

If you still have questions about getting Medicare while you’re still working, you can get more information and answers from:

  • Centers for Medicare and Medicaid Services (CMS)
  • An independent insurance broker
  • A private insurance company that offers Medicare plans, like us

You can also review our Medicare plans to find one that fits your unique situation.

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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