- Your current employment status is not a factor in whether or not you’re eligible for Medicare at age 65.
- If you initially decline Medicare coverage, you may have to pay a penalty if you decide to enroll at a later date.
You can get Medicare if you’re still working and meet the Medicare eligibility requirements.
You become eligible for Medicare once you turn 65 years old if you’re a U.S. citizen or have been a permanent resident for the past 5 years. You can also enroll in Medicare even if you’re covered by an employer medical plan.
Read on to learn more about what to do if you’re eligible for Medicare and still employed.
In many cases, it’s best to apply for Medicare Part A (hospital coverage) if and when you become eligible, even if you’re covered by a group health plan.
Medicare Part A is often available without a premium. Delaying enrollment in Part A may lead to a penalty if you sign up later.
Talk with your insurance provider and a Medicare agent to understand how enrolling in parts B and D will impact future enrollment in Medicare and access to an employer-sponsored plan.
Typically, Medicare offers a 7-month window to apply around your date of eligibility. You can apply 3 months before the month of your 65th birthday, during your birth month, and for 3 months afterward.
In many cases, you must enroll on time in order to avoid paying a late penalty in your Medicare premiums. But if you or your spouse is employed when you become eligible, you may be eligible for an 8-month special enrollment period.
During a special enrollment period, you can keep your existing group health plan for as long as it’s available. If you leave that employer or the employer terminates your coverage, you will typically have this 8-month window to enroll in Medicare without paying any late penalties.
If you’ve worked and paid Medicare taxes for at least 10 years, you may be eligible to receive premium-free Part A benefits.
Can you qualify for Medicare if you’re under 65 years old?
Most Americans become eligible for Medicare on their 65th birthday.
You may be able to receive Medicare coverage if you’re under age 65 and:
- received disability benefits for 24 months
- have end stage renal disease (ESRD)
Should you enroll in Medicare if you’re already covered by you or your spouse’s group healthcare plan? That depends.
If you’re eligible for premium-free Medicare Part A, there’s often very little downside to enrolling. You may be eligible for premium-free Part A if you paid into Medicare through payroll taxes for at least 10 years of employment.
If you work for a large company with more than 20 employees, a Medicare policy can act as a secondary payer and can help to fill in gaps in your existing coverage without any additional cost on your end.
If you work for a small company (fewer than 20 employees) or have a health insurance plan through your employer with minimal coverage, enrolling in Medicare may help reduce your medical expenses.
Medicare will often become the primary payer in these cases and may provide better coverage than you currently receive. In fact, your small employer’s insurance may not cover you if they discover you’re eligible for Medicare benefits and haven’t enrolled.
If you’re not eligible for premium-free Part A for any reason, having both Medicare and employer coverage may end up costing you more with little benefit.
Check your current plan against the most recent Medicare Part A premiums to decide if it’s worth making a switch or having both.
Medicare coverage for outpatient care, or Part B, usually comes with a monthly premium.
If you keep your employer coverage and enroll in Part B, you’ll be paying a premium for coverage you may not need or use.
If you enroll in either a Medicare Part D plan for prescription drugs or a Medicare Advantage plan that includes prescription drug coverage while you’re employed, you’ll likely lose prescription drug coverage under your employer’s plan — or potentially all of your coverage.
You’ll need to compare your current premiums and drug costs to available Medicare drug plans to see if it makes financial sense to switch.
If you contribute to a health savings account (HSA), you won’t be allowed to continue contributing under Medicare.
Money from your HSA can be spent more flexibly than insurance or Medicare benefits, so consider this carefully before enrolling.
- You’re not required to immediately enroll in Medicare if you’re eligible but still insured under an employer-sponsored plan.
- Usually, you can continue to receive benefits from your employer and enroll in Medicare when you’re ready to replace that coverage.
- You may want to join at least premium-free Medicare Part A, if you’re eligible when you turn 65 years old. The secondary coverage can help eliminate gaps in your group health plan and may help to save you money.
- If you work for a small company with fewer than 20 employees or have a health plan with your employer that provides minimal coverage, it may make sense to switch to full Medicare coverage — including Part B and prescription drug benefits.
- You’ll want to compare your current premiums and healthcare costs with Medicare premiums based on your income.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.