Do I Need Medicare If I Am Still Working?
The answer is:
It depends on your employer coverage.
Turning 65 does not automatically mean everyone who works must enroll in every part of Medicare immediately.
At the same time, continuing to work does not automatically mean you can safely delay Medicare.
You need to understand:
Who provides your health insurance?
Is the coverage based on current employment?
How many employees does the employer have?
Who pays first—Medicare or the employer plan?
Is the prescription coverage creditable?
Are you contributing to an HSA?
Working for an Employer With 20 or More Employees
If you are age 65 or older and have qualifying group health plan coverage based on your or your spouse's current employment, and the employer has 20 or more employees, the employer group health plan generally pays first and Medicare pays second.
In this situation, some people may be able to delay Medicare Part B without a late enrollment penalty while the qualifying employment and group coverage continue.
However, you should confirm this directly with your employer's benefits administrator.
Working for an Employer With Fewer Than 20 Employees
This situation can be very different.
If you are age 65 or older and the employer providing your group coverage generally has fewer than 20 employees, Medicare generally pays first and the employer group plan pays second.
If Medicare is supposed to be the primary payer and you fail to enroll, your employer insurance may not pay your medical expenses as though it were primary.
That can potentially create significant unpaid medical bills.
Do not assume a small-employer health plan allows you to delay Part A and Part B.
Confirm with the employer benefits administrator how the plan coordinates with Medicare.
What If My Spouse Is Still Working?
Qualifying coverage through your spouse's current employment may also allow you to delay Part B in certain circumstances.
Again, employer size and the type of coverage matter.
Coverage through a spouse who is actively employed can be treated differently from coverage provided by a former employer.
What If I Am Self-Employed?
Do not assume that having private or business health insurance automatically qualifies you to delay Medicare.
Ask whether your coverage qualifies as employer group health plan coverage based on current employment for Medicare purposes.
Medicare specifically recommends checking with the insurance provider if you are self-employed or have coverage that may not meet Medicare's employer group health-plan definition.