Working past age 65? What you need to know about Medicare!

Whether or not you continue working, if you are going to start taking Social Security at age 65, you will automatically be enrolled in Medicare Parts A and B. You will receive a packet in the mail from Medicare about 3 months before your birth month.

If you’ve worked 40 quarters and paid Medicare tax during that time, you qualify for Part A without having to pay the premium. Because you are taking Social Security, you will get Medicare Part A beginning the first day of the month you turn 65 (unless your birthday is on the first of the month, then coverage starts the previous month).

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Medicare Part B is a different story. If you will still be covered by a group health insurance plan THAT MEDICARE COUNTS AS CREDITABLE COVERAGE (you must check this with your benefits’ administrator) through your or your spouse’s employer, you will want to decline Part B. Follow the instructions that come in the packet from Medicare and send that card back to decline Part B. THIS IS VERY IMPORTANT. Here’s why:

a. The first six months that you are age 65 or older AND on Medicare Part B is your Medicare Supplement Open Enrollment Period. During that time, you can purchase any Medicare Supplement sold in your state without having to answer health questions. You definitely want to preserve that Open Enrollment Period until you need it. This Open Enrollment Period cannot be changed or stopped once it has started.

b. For Medicare Advantage plans, you will also miss your Initial Coverage Election Period if you take Medicare Part B while still covered by a group health plan. By declining Part B until you need it, you can be sure you will be able to enroll in a Medicare Advantage plan when you want to and not have to wait for an Annual Enrollment Period or a Special Election Period.

If you are not going to take Social Security at age 65, you can enroll in Medicare Parts A and/or B by calling Medicare 3 months before your birth month. You can sign up for A and B, or you can sign up for A only and delay B for the reasons discussed previously. BUT ONLY IF YOU HAVE CREDITABLE COVERAGE THROUGH YOUR GROUP HEALTH PLAN

Won’t there be a penalty if Medicare Part B enrollment is delayed?

NOT IF YOU HAVE CREDITABLE COVERAGE THROUGH A GROUP HEALTH PLAN.

So if you will continue working and have creditable group coverage, when should you sign up for Part B?

You can sign up anytime while you are still covered under your creditable coverage group health plan, choosing an effective date after that group coverage will end. Or, you will have an 8 month Special Election Period to sign up for Part B that begins after the group coverage or employment ends, whichever is first.

What if you take Part B, then return to work at an employer with creditable coverage and drop Part B?

You can do that, but be aware, you will not have another Medicare Supplement Open Enrollment Period if you rejoin Part B again later. That open enrollment period is once per lifetime.

One last thing. What about the size of your company?

Employers with 20 or more employees must offer current employees age 65 and older the same health benefits, under the same conditions, that they offer to employees under age 65. If the employer offers coverage to spouses, they must offer the same coverage to spouses 65 and older that they offer to spouses under 65.

If your or your spouse's employer has 20 or more employees, then the group health plan is the primary payor and pays first, and Medicare is the secondary payor and pays second.

If the group health plan didn't pay all of your bill, the doctor or health care provider should send the bill to Medicare for secondary payment. Medicare will pay based on what the group health plan paid, what the group health plan allowed, and what the doctor or health care provider charged on the claim. You'll have to pay any costs Medicare or the group health plan doesn't cover.

• If your or your spouse's employer has fewer than 20 employees and isn't part of a multi-employer or multiple employer group health plan, then Medicare pays first, and the group health plan pays second. In this case, your employer insurance is the secondary payer and you may have to enroll in Medicare Part B at age 65 before your insurance will pay.

• It is imperative that you speak with your group health benefits administrator more than three months before the month you turn 65 so you know what options are available to you.

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