Here at Senior Insurance Advisors, we are often asked whether Medicare is mandatory. For such a common question, there is no one-size-fits-all answer. Whether or not enrollment is mandatory depends largely on your age, employment status, and other factors.
Enrolling in Medicare is an important decision, especially as you near retirement age. If you are already receiving Social Security or Railroad Retirement Board benefits before you turn 65, you will automatically be enrolled in Original Medicare (Parts A and B) for the first day of the month you turn 65. If your birthday happens to fall on the 1st, Medicare coverage will start the first day of the month preceding your 65th birthday.
You have the choice whether to pay a Part B premium or opt out of the coverage. It is important to note, however, that delaying your enrollment in Part B coverage can result in a late enrollment penalty assessed over the lifetime of your policy. From age 65 on, you have the opportunity to reassess your coverage annually during the Medicare Annual Enrollment Period (AEP). During this enrollment period, you can more easily adjust your coverage to best match your needs.
Medicare Part A is not mandatory if you are still working at 65. We do, however, generally recommend that you enroll as soon as you become eligible even if you do not plan to retire at this age. Individuals who are Medicare-eligible but covered under their employer’s group health insurance plan can enroll in Medicare Part B during a Special Enrollment Period (SEP). This allows you to add Part B coverage to your existing plan outside of general enrollment, and without the penalties of a late enrollment.
For most people, Medicare Part A does not require you to pay a monthly premium. This is the case if you have been employed in the U.S. for at least 10 years. Even with employer-provided health coverage, Medicare Part A can help cover some hospital costs that you would have otherwise paid for out of pocket. If you are contributing to an HSA, though, it may not be in your best interest to enroll in Medicare Part A right away. You may want to delay coverage under Part A to ensure you can still make HSA contributions.
Individuals under the age of 65 who are receiving disability benefits are also automatically enrolled in Medicare Part A and Part B in some cases. You must have received these benefits—whether from Social Security or the RRB—for a period of 24 months in order for this enrollment to take place. If you have ALS, Medicare Part A and Part B coverage begins automatically the same month as your Social Security disability benefits.
For individuals receiving Social Security benefits, Medicare Part A often goes hand-in-hand. The other parts of Medicare, however, offer a greater degree of flexibility. Prospective enrollees must take into account their age as it relates to Medicare’s various enrollment periods, as well as their employment and disability status. If you still have questions about which Medicare coverage is right for you, we encourage you to reach out for a free consultation!
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We are licensed and represent plans and carriers in AZ, CO, IA, KS, MN, MO, NE, SC, SD, TX, and WA. The following disclaimer is for Lancaster county in Nebraska, where we reside.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 53 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all your options.Not affiliated with or endorsed by the government or federal Medicare program. Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. By providing the information above, I grant permission for a licensed insurance agent to contact me regarding my Medicare options including Medicare Supplement, Medicare Advantage, Prescription Drug plans.