2021 Medicare Parts A & B Premiums and Deductibles

2021 Medicare Parts A & B Premiums and Deductibles

Ask Bob: Do I Need to Sign Up for Medicare If I Have Employer-sponsored Health Insurance?

What are the requirements and options for signing up for Medicare when you have employer-sponsored health insurance?
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Question

I’m 64 and retired and presently on my wife’s employer-sponsored health insurance plan. 

My questions:

At age 65, do I have to sign up for Medicare Part A only and wait to sign up for Part B and D after she retires? Or do I need to sign up at age 65 for Parts B and D?

Also, what about Medicare Advantage and Medigap? Would I need to sign up for Medicare Advantage at age 65 if that’s the kind of plan I want? Ditto Medigap. Do I need sign up at age 65 or can I wait until my wife retires? Also, are there any penalties and enrollment dates that I need to worry about?

Answer

These questions are pretty complex, can depend to some degree on particulars that are not included here, and the answers to one question affect the others, says Casey Schwarz, senior counsel for education and policy, Medicare Rights Center. She notes that people in this situation should seek individualized assistance from organizations like Medicare Rights or a State Health Insurance Assistance Program (SHIP), as her answers are generalized.

“If your wife is still currently employed with the company sponsoring the health insurance plan, AND that employer has more than 20 employees, you can consider signing up for Part A and delaying Part B.” says Schwarz. “You need to have insurance from your or your spouse’s current work to be able to sign up for Part B later without having to wait for coverage and possibly pay a penalty. And you need that current work insurance to be from an employer with more than 20 people so that that insurance is primary.”

“If the insurance is not from current work or the employer is small, you will want to enroll in Part A and Part B,” she adds, noting “You can still keep the employer coverage, it will pay after Medicare.”

If your wife’s employer-sponsored health plan is from current work OR retirement benefits, you can delay Part D if the drug coverage under that plan is “creditable” or actuarially equivalent to Part D’s basic benefit, Schwarz explains. “Your wife’s employer should be able to provide you with that information. If the coverage is not creditable, you will need to enroll in Part D or you will pay a penalty when you later enroll.”

Your timeline for Medigap and Medicare Advantage decisions, she says, depends on when you enroll in Part A and Part B. “Your federal Medigap Open enrollment rights start the first time you are over 65 and enrolled in Part A and Part B. So if, after the information above, you decide to wait to enroll in Part B until your wife leaves her job, you will be able to choose a Medigap without Medical Underwriting at that time.” In addition, you may also have federal guaranteed issue protections or state-specific open enrollment or guaranteed issue periods– other times you can buy a Medigap without medical underwriting based on specific circumstances.

Schwarz adds, “You have an initial coordinated enrollment period for Medicare Advantage when you are first enrolled in Part A and Part B, or you can use the annual fall open enrollment period to select a Medicare Advantage plan for the next year.”

Got questions? Get Answers!

Email Robert.Powell@maven.io. 

Question

I’m 64 and retired and presently on my wife’s employer-sponsored health insurance plan. 

My questions:

At age 65, do I have to sign up for Medicare Part A only and wait to sign up for Part B and D after she retires? Or do I need to sign up at age 65 for Parts B and D?

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