Common Medicare Questions

Still have questions about Medicare? We can answer them for you. We receive questions every day from our clients, and have compiled a list of those we are asked most frequently. If you don’t see the answer to the questions that you have, contact us and we will speak to you personally!

If I or my spouse are working past 65, should I enroll in Medicare or remain on my employer plan?

  1. There are a couple of things that might lead you to enroll in Medicare when you first turn 65 despite being employed. First, per CMS, if your employer has less than 20 employees, Medicare will become your primary because your employer coverage at 65 will shift to a supplemental position and thus, not be the first payor of claims. Second, if your employer coverage for both medical and prescription is not deemed creditable. If you remain on a plan that does not meet or exceed Medicare standards, you could face penalties when you finally decide to enroll in Parts A and B as well as Part D. If you fail to enroll when first eligible, you can face the loss of guaranteed issue associated with Medicare Supplements. Note: This isn’t always the case, but due to the risk and penalties, please check with your employer or your spouse’s employer to better understand your options.
  2. If you work for an employer with over 20 employees and the coverage is creditable for Parts A, B and D, you have the option to delay your enrollment. If you meet this criteria, by delaying enrollment you will not incur any penalties for Parts A, B and D. You would be eligible to enroll in Medicare Parts A, B and D under a Special Enrollment Period (SEP) when you finally lose coverage. Qualifying for an SEP through loss of employer coverage, you will have an 8-month period in which to enroll into Medicare Parts A, B and Medicare Supplement. Note: If you elect to enroll in Part B while working, please discuss this with your employer as well as find out the impact on your Medicap Open Enrollment period, since once it’s started, it cannot be changed or restarted.
  3. If you seek to enroll in Medicare Advantage or Part D under your SEP, you can enroll in these plans from the month that you lose coverage and the two months that follow. The individual in this scenario can apply for an effective date or start date of these plans up to 3 months from the date they completed their enrollment request. Note: You must be enrolled in Parts A and/or B for Part D plans and you must be enrolled in Parts A and B for Medicare Advantage.

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