Why Switch to Medicare After Age 65 if You Have Employer Coverage?

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Contributor, Benzinga
November 8, 2022

I’m 66 now, still working, and I am enrolled in a health coverage plan that my employer provides. Is there any reason I should take Medicare? Is there a penalty if I don’t? And am I allowed to switch later on?

Jim, New York City

Jim is not alone in asking those questions. You could be asking them too if you are trying to navigate the transition from an employer-provided plan to Medicare whether or not you are collecting social security.  So in today’s article, let’s answer them, along with some others about the health plan and monthly premiums you might not have considered yet.

Do You Have to Sign Up for Medicare at Age 65?

Actually, you don’t. Whether or not you have coverage through your employer, you can decide at age 65 that you would like to delay enrollment.

You can sign up later for Medicare, with no penalty, during one of the Special Enrollment Periods that occur annually without a late enrollment penalty. But certain rules and restrictions apply, so you should get some expert guidance and make sure your employer’s plan is considered “Creditable” by Medicare.

Are There Advantages to Keeping Your Employer-Provided Plan?

There could be, so ask whether your employer’s plan provides any benefits that you won’t get through Part A basic Medicare, or which could cost a lot if you enroll in a Medicare Advantage plan. Does your employer plan, for example, cover dental, vision, and specific procedures you are considering, like dental implants?

If you are married, what about your spouse’s coverage? If your employer-provided plan covers him or her, think about how much extra it could cost to obtain their medical insurance coverage.

Can You Be Enrolled in Both Medicare and Your Employer’s Plan at the Same Time?

Yes, you can. For example, if both you and your spouse are still working and enrolled in your employers’ plans, you can get additional coverage by enrolling in Medicare Part A (original Medicare) and Part B.

But you might need to get some expert advice to answer certain questions because there are a number of “moving parts” and you don’t want to make mistakes. For example, if both you and your spouse are enrolled in both Medicare and in an employer-provided plan, which of those plans will you use as your (or your spouse’s) primary provider when you file claims?  If you use your employer coverage as your primary insurer, for example, it will pay healthcare costs first and Medicare will step in and pay some or all of the remaining portion. Also, which one will cover your prescription drug costs?

One Simple Thing to Keep in Mind

Medicare is complicated. There are different “Parts” to consider (Part A, Part B, Part D), enrollment periods, and on and on the complication goes.

It can be tricky to understand all those moving parts as you make your decision whether to enroll in Medicare. In contrast, an employer’s plan is easy to understand. Chances are you have received a booklet that outlines what is covered, or you can learn the details on the plan website. You can also track how much that coverage is costing you simply by looking at how much is being deducted from your paycheck. That can make it easier to make the decision of whether to keep your old plan – and how much of it to retain, if any, when you start to be covered by Medicare.

Where Can You Get Help Deciding?

Visit CoverRight.com they’ll help you find the right Medicare coverage based on your personal situation. Reach out today and find the best Medicare plan for you.

CoverRight.com is a digital-first health insurance platform focused on Medicare. The company’s mission is to make Medicare more transparent and accessible for America’s 60 million Medicare beneficiaries. They aim to simplify a traditionally confusing and complex decision by delivering you a simple, delightful, and comprehensive enrollment experience. They have Medicare professionals available to assist with all areas of the enrollment process.


Does everyone automatically get Medicare at 65?


If you are receiving social security benefits, you will automatically be enrolled in Part A and Part B Medicare plans.


What is the cost of Medicare for a 65 year old?


Depending on how long you or your spouse worked, you will pay $278 or $506 in 2023 for Medicare.


Do I need to contact Social Security when I turn 65?


Yes, you should contact Social Security in the three months before you turn 65.