Turning 65 is a major milestone, and for many people, it brings up questions about Medicare. One of the most common concerns we hear is this: Do I have to enroll in Medicare if I’m still working and have health insurance through my employer? The answer depends on several factors, including the size of your company and the type of health coverage you have.

Employer Size Matters

If you work for a company with 20 or more employees, your group health plan is considered primary, and Medicare is secondary. In this case, you are not required to enroll in Medicare Part B right away. Many people in this situation delay enrolling in Part B to avoid paying the monthly premium while they still have good coverage through work.

However, if your employer has fewer than 20 employees, Medicare becomes the primary payer. In that case, you need to enroll in Medicare when you turn 65 to avoid potential gaps in coverage and late enrollment penalties. Your group plan would then become secondary.

Understanding Your Options

Even if you’re not required to enroll in Medicare, you may choose to enroll in Medicare Part A, which is premium-free for most people. It can serve as secondary insurance and may help cover hospital costs not paid by your group plan.

You can delay Part B and Part D (prescription coverage) without penalty if you have creditable employer coverage. Once your employment or coverage ends, you have a special enrollment period to sign up for Medicare without facing late fees.

Coordination of Benefits

If you choose to enroll in Medicare while still working, your benefits will coordinate between Medicare and your group health plan. Which plan pays first depends on your employment status and employer size. This coordination helps prevent duplicate payments and ensures that medical costs are handled properly.

Get Knowledgeable Guidance

Medicare decisions can be complex, especially when employer coverage is involved. Choosing the right path depends on your unique situation, and making the wrong decision could result in higher costs later.

If you’re approaching age 65 and still working, reach out to one of our knowledgeable licensed insurance brokers.  We’ll help you understand your options and ensure you make the best decision for your health and finances.