Do I Have to Sign Up for Medicare When I Turn 65?

Jan 20, 2023

Everyone’s specific circumstances will determine whether they must sign up for Medicare at 65, meaning that there’s more than one answer to the question. However, it is imperative to know the correct answer to the question  – Do I have to sign up for Medicare at 65? –  to avoid paying a late penalty.

It’s important to know that the moment you enroll in Social Security, you must sign up for Medicare Part A, no matter what. However, you can delay enrolling in Part B, Part C, and Part D if you have creditable coverage.

Therefore, we cannot give you a straight yes or no answer because the answer to the question about signing up for Medicare at 65 will depend on your answers to the following questions:

  •       Have you retired?
  •       Do you still work?
  •       How many employees work at the company where you are employed?
  •       What type of employer group health coverage do you have?

Read on to discover if you must sign up for Medicare at age 65 according to your answers to the above questions.

What must you do about Medicare if you have retired?

After retirement, this is what Medicare.gov suggests you do.

If you have retired, you must sign up for Medicare at age 65 or as soon as you become eligible to avoid paying a late penalty.

Even if you have retiree health coverage from a former employer, signing up for Medicare parts A and B is mandatory because it remains a primary requirement of these plans. In addition, you may face a penalty if you don’t join when you are first eligible. Retiree plans and Medicare provide substantial coverage thanks to their structure.

Suppose you have retired without retiree coverage from a former employer but have Health Insurance from the ACA Health Insurance Marketplace. Then you must sign up for Medicare at 65, even if you pay premiums for Part A. Failure to do so can result in a late penalty and delayed coverage. You could also lose other Social Security benefits. However, you can not lose social security benefits for not enrolling in Medicare

What happens with Medicare if you are still working?

If you are still working, the question about how many employees work at your company becomes most relevant. The number of employees determines whether you have to sign up for Medicare when you turn 65.

Less than 20 employees

If you work for a company with 20 employees or fewer, you must sign up as soon as you become eligible to avoid paying a late penalty. You will need Part A and Part B because Medicare is the primary health coverage for small companies.

More than 20 employees

You will have more extensive employer coverage if the company has more than 20 employees.

Your employer group health coverage provides creditable coverage giving you the first option of delaying your Medicare enrollment. You can delay until you lose the creditable coverage without paying the late penalty because your coverage is primary at this stage, meaning that Medicare is secondary.

What many people do when they have creditable coverage is to enroll in Part A at 65, delaying enrolling in the rest of Medicare until they retire.

However, the delay in enrolling in the other parts of Medicare may not prove wise. Read on to find out how your employer group health coverage can affect whether it’s best to enroll in Medicare and coordinate it with your employer coverage or to delay it.

What type of employer group health coverage do you have?

Yes, the kind of employer group health coverage can affect whether you enroll in Medicare at 65 while working. If the group health plan offered by your employer is top-notch, then you have all the coverage required and don’t need to enroll in Medicare yet.

On the other hand, if it is not such a great plan, adding Medicare can help supplement the group plan’s primary, reducing your health expenditure as your secondary coverage. However, whether you sign up for Medicare or not at 65 would also depend on if you need more robust coverage because of a health issue.

Is Enrolling in Medicare Part A important?

Yes, because Part A costs most people $0/month if they have worked for at least 40 quarters in the U.S. With Medicare Part A, you can reduce your group health plan spending if you have an in-hospital stay. In addition, if you contribute to a health savings account, you can delay enrolling in Medicare until you retire.

How do you pay late penalties?

Medicare adds late penalties to the monthly premiums when you decide to enroll. They remain in force the entire time of your enrollment. Of course, you won’t pay the penalties if you never enroll, but you will need Medicare sooner or later, so don’t let them accrue.

Final take

Do I have to sign up for Medicare when I turn 65? Our Medicare experts can help you answer your question. Remember, your Medicare enrollment and avoiding paying a late penalty depends on whether you have retired or are still working, the number of employees in your company, and your employer’s health coverage.