Postponing Medicare Enrollment: Crucial Information You Need
Enrolling in Medicare for Couples: A Guide for the Employed
When one spouse is nearing the age of 65 and working for an employer, the process of enrolling in Medicare can be unclear, especially when both spouses have employer-provided health insurance. Here is a breakdown of the key factors to consider in these situations.
Rule Depends on Employer Size and Coverage
In cases where both spouses are working for an employer with 20 or more employees, their employer-provided health insurance will often act as the primary coverage, positioning Medicare as the secondary coverage. In this scenario, you can delay Medicare Part B enrollment without incurring any penalties, as long as you maintain credible health coverage through your employer[1][2][3].
However, if either spouse works for an employer with fewer than 20 employees, Medicare will usually be the primary coverage, and it is advised to enroll in both Part A and Part B when you turn 65 [4].
Medicare Enrollment Options
Part A: If you have worked and paid Medicare taxes for a minimum of 40 quarters (10 years), you can enroll in Medicare Part A without any premium. It is generally advantageous to enroll in Part A, even if you have employer coverage, as it can provide additional benefits without cost [4].
Part B: If you have credible health coverage through an employer with 20 or more employees, you may postpone enrolling in Part B until you retire or lose your employer coverage. In such circumstances, you can enroll in Part B without penalty during your employment or within the first eight months following the loss of active employee coverage [2][3].
Special Enrollment Periods (SEPs)
Should you delay Part B enrollment while covered by an employer plan, you become eligible for a Special Enrollment Period (SEP) to enroll in Part B without penalty when you cease employment or lose coverage [2].
Interplay with Marketplace Plans
If you have a Marketplace plan instead of employer-provided coverage, it is advisable to enroll in Medicare when you turn 65 and communicate with your Marketplace plan. This is because your Marketplace plan will not automatically cancel, and you will forfeit eligibility for premium tax credits [2].
Coordination With COBRA
If you move onto COBRA after losing employer coverage, Medicare will be the primary coverage when present, with COBRA acting as the secondary coverage. It is essential to enroll in Medicare Part B within eight months of losing active employee coverage to avoid penalties [1].
In conclusion, couples with employer coverage can postpone Medicare Part B enrollment if their employers have 20 or more employees, but it is usually advantageous to enroll in Part A. Always consult with your benefits administrator to gain a thorough understanding of how your specific situation interacts with Medicare and employer-provided health insurance.
[1] Medicare.gov https://www.medicare.gov/part-a-costs/part-a-costs.html[2] healthcare.gov https://www.healthcare.gov/medicare-and-you/part-b/how-do-i-get-part-b/[3] Investopedia.com https://www.investopedia.com/terms/h/hcfa.asp[4] Ssa.gov https://www.ssa.gov/planners/retire/medicare.html
- In situations where both spouses work for an employer with 20 or more employees, having employer-provided health insurance may allow one to delay enrolling in Medicare Part B without incurring penalties, while it's advantageous to enroll in Part A, even with employer coverage.
- For couples where one spouse works for a smaller employer with fewer than 20 employees, it's often advisable to enroll in both Part A and Part B when you turn 65.
- If a Marketplace plan is chosen instead of employer-provided coverage, it's essential to enroll in Medicare when turning 65 and communicate with the Marketplace plan, as the Marketplace plan will not automatically cancel, and eligibility for premium tax credits might be forfeited.
- When moving onto COBRA after losing employer coverage, it's crucial to enroll in Medicare Part B within eight months to avoid penalties, with Medicare functioning as the primary coverage and COBRA acting as the secondary coverage in this scenario.
