Medicare is the United States’ health insurance program commonly used for individuals 65+ and those with disabilities. Making the switch from the traditional healthcare marketplace to Medicare can be overwhelming and confusing. M3 Elevate’s Medicare team can help you or your employees throughout the transition and offer personalized support.
When enrolling in Medicare, timing is critical to avoid late penalties or delay in coverage. The sections below walk through the transition of turning 65, if you are/are not on an employer group plan during this time, and how it affects your Health Savings Account.
Do I Need to Sign Up for Medicare When I Turn 65?
It depends! Everyone is in a different situation, so the timing could be different from one person to the next. We recommend the “3-month rule”: 3 months prior to turning 65, start asking the question of when you need to enroll and what parts of Medicare you should enroll in. Once you have worked with our team to determine the best solution, you can begin the Medicare sign up process. As a reminder, there are four parts of Medicare: Medicare Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage Plan optional plan to purchase once you have Part A and B), and Part D (prescription drug coverage).
Turning 65 and not on an employer group plan
If you are turning 65 and not on an employer group plan (either from you or your spouse), you should sign up for Medicare Part A and B when you are first eligible during your initial enrollment period. You will also want to look at additional coverage such as a Medicare Advantage Plan or a Medicare Supplemental plan partnered with a Part D plan. Our M3 Elevate Medicare team can partner with you to determine the best coverage to fit your individual needs.
Turning 65 and on an employer group plan
If you are turning 65 and on an employer group plan (either from you or your spouse) and the employer has less than 20 employees, you should sign up for Medicare Part A and B. You can still have the employer plan, but Medicare is going to pay primary in this situation. You can enroll in additional Medicare coverage in the event you do not want to stay on your employer plan. Depending on your health costs and plan costs, it could be more cost effective to go on full Medicare and drop your group plan or vice versa.
If you are turning 65 and on an employer group plan (either from you or your spouse) and the employer has 20 or more employees, you can choose to sign up for Medicare Part A and B, or delay signing up until retirement. If you are currently collecting Social Security benefits, you are automatically enrolled in Part A and B and only able to decline Part B. Your employer plan pays primary to Medicare in this situation. You will have a special enrollment period during the time of retirement to enroll in Part A and/or B. You will apply for additional coverage for Medicare at that time as well. Again, depending on your health costs and plan costs, it could be more cost effective to go on full Medicare and drop your group plan or vice versa.
When you continue working over the age of 65, it can be confusing to understand which parts of Medicare you should enroll in and how they interact with your employer or private coverage. Learn more about Medicare coverage for individuals working past 65 and how employer coverage works with Medicare Part A and B.
If you are turning 65 and on an employer group plan (either from you or your spouse), the employer has 20 or more employees, and you wish to contribute to a Health Savings Account (HSA) – you must delay both Medicare Part A and B. You cannot be on Medicare and contribute to an HSA. If you have applied for or are receiving Social Security benefits, which automatically entitle you to Medicare Part A, you cannot contribute to your HSA. You should stop contributing funds to your HSA six months prior to collecting Social Security benefits. You will have a special enrollment period at your retirement to enroll in Part A and/or B. You will apply for additional coverage for Medicare then too.
Key Takeaway
If you or your employees are turning 65 or became eligible for Medicare earlier due to a disability, it is important to understand Medicare enrollment timing and how it works with employer coverage or private coverage. Contact your M3 Elevate advisor today to help alleviate the stress of determining the best solution when it comes to your healthcare coverage.
Source: Medicare.gov
Please Note:
We do not offer every plan available in your area. Currently we represent 15 organizations which offer 76 products in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local state health insurance program to get information on all of your options.
