Turning 65 and Still Working?  Learn the Facts about your Medicare Options

By: Lupe Bruneman, HCMBA
Ph: (786) 322.8633

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Are you employed and 65 or older? “The Bureau of Labor Statistics (BLS) indicates that in 2020, 10.6 million people 65 and older were in the workforce. Breaking down that number further, 26.6% in the age group 65 to 74 were working, while the percentage was at 8.9% for those 75 and older.” (forbes.com, 11/14/21). 

This trend is only increasing as the number of people born in the Baby Boomer years are aging-in to Medicare (if you were born between 1946 and 1964, you are a Baby Boomer). It is projected that by 2030 all Baby Boomers will be Age 65.

The following are FACTS about your options related to Medicare if you are still working beyond Age 65:

1. If you are working for a company employing more than 20 employees, then this is considered a “large employer,” and the insurance coverage is “creditable”. “Medicare creditable coverage is coverage that is considered just as good as Medicare, meaning that the coverage pays as well as Medicare does. When someone has creditable coverage for Medicare, they can delay enrollment in Medicare without owing a late enrollment penalty.” (boomerbenefits.com, 10/4/21)
2. In this case, the following are your options:
   1. Keep your current insurance with your employer and ONLY APPLY FOR PART A MEDICARE. If you have been paying Medicare tax through salary payroll deductions, then there will NOT be a cost to Part A.
   2. Compare Medicare options and give up your employer coverage to move over to Medicare. You should consider comparing (a) Premium cost; (b) Deductibles; (c) physician participation, and (d) medication costs between your current employer coverage and what your Medicare coverage would be.  Pick the one that is better for you!
   3. If you keep your employer and also get Part A, Medicare will be considered SECONDARY to your employer coverage. Meaning you will have to meet all out-of-pocket costs applicable from your employer coverage before Medicare steps in to cover any applicable Hospital costs, and you will have to pay a hospital deductible of $1,556 (as of 1/1/22).

If you keep your employer coverage AND decide to enroll in both Medicare Parts A and B, YOU HAVE TOO MUCH INSURANCE!! There is no need to get Medicare Part B if you are covered under your “creditable” employer coverage. 

If you decide to put off Medicare Part B, make sure you start planning to apply for Part B at least 3 months before you are giving up employer coverage. Applying for Part B is done either online through www.ssa.gov or by setting an appointment with your local Social Security office. Before fully leaving your employer, make sure they complete a CMS-564 form, which will let Social Security know you have been covered by creditable coverage. If you need any assistance with any of these processes or have any questions, please contact me, and we will guide you!