As you approach the age of 65, you may be looking for ways to downsize and cut your monthly expenses. Your monthly health insurance premium is a sizeable monthly cost. It would be nice if you could go on Medicare and not have to continue paying your health insurance premiums. You may also be interested in carrying both your medical coverage and have Medicare. This article answers the question you may be asking, “I have medical coverage, can I get Medicare too?”
It is a simple question, but the answer is, unfortunately, not so simple. It will depend on three factors:
- Your age
- Whether you have a disability
- The size of your employer
Often, it is not an issue of whether you may have both your employer coverage and Medicare. Even if you have employer medical coverage, you can be penalized for late enrollment, if you do not sign up for Medicare when supposed to.
Under age 65
If you are under age 65 and have employer coverage, and you have not received Social Security benefits for at least four months before you become 65, you must sign up for Parts A and B of Medicare. Part A is hospital insurance, and is usually free. Part B is medical insurance, which requires that you pay a monthly premium, whether you use it or not.
If your employer has fewer than 20 employees, you must enroll in Medicare Parts A and B when you are eligible, to avoid a gap in coverage and a late enrollment penalty. If you do not sign up for Parts A and B when you are supposed to, you may have a late enrollment penalty tacked on to your premiums for the rest of your life.
If your employer has 20 or more employees, check with your HR or benefits manager to see if your coverage meets the IRS requirements for “group health plan coverage.” If it does, you might hold off on enrolling in both Parts A and B and avoid the late enrollment penalty.
Over age 65
If you are over age 65 and you did not enroll when you were first eligible, you cannot go back and reset the clock. When you eventually retire or lose employer coverage, and then sign up for Medicare, you may have to pay a penalty, depending on the size of your employer.
Under age 65 with a disability
Similar to being over age 65 but not yet on Medicare, you must enroll when you eventually retire or lose employer coverage. The number of employees your employer has, will determine whether you must pay a late enrollment penalty when you enroll in Medicare.
With some disabilities, however, enrolling in Part B is optional if you qualify for Part A. There is also no late enrollment penalty when you enroll eventually. You can even have your late enrollment penalty removed, if you are later diagnosed with a qualifying disability.
The rules for Medicare are complicated, and they can change. If you make a mistake, it could cost you higher premiums for the rest of your life. The laws are different in every state, so check with an elder law attorney in your area.
U.S. Centers for Medicare & Medicaid Services. “I have employer coverage.” (accessed August 2, 2017) https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/employer-coverage/i-have-employer-coverage.html#collapse-5569