Turning 65
Ken Connolly
Licensed Life and
Health Insurance Broker
Written 4/22/2024
Turning 65
Intro | Should I Take Medicare Now?
|How To Signup For Medicare | Medicare Secondary Options |
I'm Turning 65 But My Spouse Is Not |
Medicare Disability | Medicaid
Introduction
Congratulations on turning 65! While it may seem crazy that you've gotten to this point, you may now join Medicare – and many people are shocked at how great Medicare can be! Let us guide you through what to expect when you reach 65.
When Do I Start Medicare?
Despite what you may have read, in many cases you do not have to make Medicare your primary insurance at 65. And if you have a little bit of help and direction, avoiding the dreaded Medicare penalties is easy!
There are many variables to consider when turning 65. Do you have work insurance? Does your spouse? Are you on insurance from the marketplace with a subsidy? Do you have retiree coverage from your employer?
The best way to decide if you should go onto Medicare is to sit with one of our brokers and get a full Medicare education. Once you get that education, we will go over all your options based on your unique situation. We will compare your monthly premiums, deductibles, drug costs, and most importantly your Maximum Out-of-Pocket costs with each option available to see which is best for you.
Do I Have to Take Medicare When I Turn 65?
It depends! If you have creditable employer coverage through you or your spouse's current employment, you may not have to join Medicare when you turn 65. In general, “creditable” employer insurance is offered by an employer that has more than 20 employees. When you have creditable employer insurance, you can typically keep that insurance until you are ready to retire without accruing any Medicare penalty. Many insurance agents and brokers incorrectly discuss Medicare penalties to scare people into taking Medicare earlier than needed. The truth is, you won't accrue Medicare penalties if you have creditable employer coverage and sign up correctly in the future.
While you don't have to join Medicare at 65 if you have creditable employer coverage, we highly recommend considering it. Many people love Original Medicare or Medicare Advantage and find it has better coverage or is more cost effective than their current work insurance.
If you are not offered credible employed-based insurance, you will likely need to join Medicare at 65. Situations in which you must join Medicare at 65 to avoid penalties include:
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You don't have creditable employer coverage at 65 (your employer offering you insurance has less than 20 employees)
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You are on a Marketplace health plan from Healthcare.gov or Get Covered NJ
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You are self-employed or purchased your own private insurance
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You are on Medicaid
To learn more about if you need to join Medicare at 65, read our article: When Do I Have To Take Medicare?
Should I Take Medicare at 65?
There are many variables to consider when turning 65 when it comes to joining Medicare or not. Do you have insurance offered by your employer? Does your spouse? Are you self-employed? Are you on insurance from the marketplace with a subsidy? Do you have retiree coverage from your employer?
The best way to decide whether to make Medicare your primary insurance is to sit with one of our brokers and get a complete Medicare education. During this time, we will review all your options based on your unique situation. Once we determine if you have to join Medicare, we will compare your monthly premiums, deductibles, drug costs, and, most importantly, your maximum out-of-pocket costs with each option available to see which is best for you.
To learn more about choosing Medicare at 65, read our article: Comparing Medicare to Work Insurance and Retiree Coverage
How To Sign Up For Medicare
Social Security manages Medicare. You can sign up for Medicare in many ways, but we recommend doing so through the www.ssa.gov online portal. You can also schedule an appointment with Social Security over the phone or in person. However, these options often take longer than the online application. If you have elected Social Security before age 65, you will automatically be signed up for Medicare.
We have helped hundreds of people sign up for Medicare correctly each year and are happy to help you do the same! Please schedule an appointment with one of our trusted brokers today to guide you through the process and make it easy.
To learn more about the different ways to sign up for Medicare, read our article: Signing Up for Medicare
Secondary Plan Options
While Original Medicare is great, most Medicare enrollees get additional Medicare secondary plans to get extra coverage and benefits. Which option you choose is a big decision that you should consider in depth before joining Medicare because not all options may be available to you after turning 65. To learn more about the different secondary plans available to you, read some of our articles below:
Medicare Supplements (or Medigap) plans help eliminate your Out-of-Pocket Hospital and Medical costs under Original Medicare for a reasonable monthly premium.
Medicare Prescription Drug Plans offer prescription coverage, which Original Medicare does not cover.
Medicare Advantage plans bundle coverage for hospitals, medical care, prescriptions, and more. These plans often also provide dental, vision, gym memberships, and more benefits.
I'm Turning 65, But My Spouse is Not
Medicare coverage is always individualized. While your spouse and you can get the same Medicare secondary plans, they are never bundled together like marketplace or employer insurance.
If you are employed and insured by your employer when turning 65, you must consider whether taking Medicare or keeping your work insurance to cover your spouse makes sense. Conversely, your spouse may have better work insurance than Medicare, and you can delay Medicare for a few years.
Choosing to go onto Medicare when your spouse is under 65 is a big decision. We recommend speaking to one of our brokers to get a Medicare education and present a comparison of all your options. It can often be cost-effective for one spouse to go onto Medicare and the other to stay on work insurance. The opposite can also be true. Please speak with us to see what your best option is.
Please read our article: I'm Turning 65, But My Spouse Is Not for a more detailed analysis.
How to Delay Medicare
Suppose you have decided to delay making Medicare your primary insurance at 65. In that case, we recommend proactively signing up for Medicare Part A online. On the same application, choose not to take Medicare Part B. Medicare Part A, in most cases, costs nothing and doesn't affect your current work insurance. However, Medicare Part B has a monthly premium and can potentially get tangled with your work insurance.
When you or your spouse are a few months away from retiring, contact us, and we will help you send the paperwork necessary to sign up for Medicare after 65 with no hassle and no penalties.
You can also read these articles if you'd like more information: How To Delay Medicare the Right Way
Medicare Disability
If you are on Medicare Disability, you have already taken Medicare before turning 65. The nice thing is that you now get another Initial Enrollment period to assess your Medicare options. If you would like to take a Medicare Supplement for the first time or would like to switch Medicare Supplements, you can do so without having to answer any health questions. You will also have some new Medicare supplement plan options available to you.
For more information, click the link to our article: Medicare Disability.
Medicaid
When you turn 65 and are on Medicaid, you may become "Dual Eligible." Dual Eligibility is for people who are eligible for both Medicare and Medicaid. You can enroll in dual-eligible plans that may include extra benefits that Medicare and Medicaid do not cover.
When you turn 65, the standards for keeping Medicaid may rise. Be sure to check your Medicaid enrollment status to see if you can continue to keep it. Many people are no longer eligible for Medicaid upon becoming eligible for Medicare. You can lose Medicaid eligibility at 65 or earlier upon enrolling in Medicare Disability.
For more information, click on the link to our article: Medicaid
