How Do I Delay Medicare?
Jo Gallo
Licensed Life and Health Insurance Broker
Written 4/17/2024
How Do I Delay Medicare?
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
"I would give Jo more stars if I could!
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You don’t always have to make Medicare your primary insurance at 65
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There are many ways to delay Medicare until you are ready
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Delaying Medicare the right way can make Medicare enrollment in the future easier
When you approach 65, you are faced with a decision: Should I make Medicare my primary insurance?
Contrary to popular belief, you often don’t have to make Medicare your primary insurance at 65. If you meet specific criteria, you can delay it. However, there is a proper way to delay Medicare that allows you to avoid penalties and hassle later.
In this article, we’ll talk about what it means to delay Medicare, what situations allow you to do so, the different ways to delay Medicare, and how to make Medicare your primary later. Let’s dive in!
What Do We Mean By “Delay Medicare”?
Delaying Medicare means that you are choosing to decline your Medicare Part B benefits. You can delay Medicare Part B when you first become eligible for Medicare if you or your spouse has creditable work coverage. Creditable work coverage is health insurance provided through employment that an actuary has determined to be as good as or better than Medicare on the prescription side. The company providing your insurance must also have more than 20 employees. If your or your spouse's employer offers creditable work coverage, they will often inform you beforehand.
In this situation, you will keep Medicare Part A. Medicare Part A is free for most people and usually doesn’t interfere with work insurance. Most of your Medicare costs are accumulated through Part B, so we focus on this when delaying Medicare.
When Can’t I Delay Medicare?
As shown above, you can delay Medicare if you or your spouse has creditable work coverage. In any other situation, you most likely can’t delay your Medicare when you first become eligible. No one will ever force you to take Medicare, but choosing not to enroll can lead to lifelong penalties and long gaps in health insurance coverage.
Some common situations where you can’t delay Medicare include:
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You have a Marketplace insurance plan like those from Healthcare.gov or Get Covered NJ
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You have Retiree coverage from your employer
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Your employer has less than 20 employees
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You’re on Medicaid and could potentially lose it
To explore these situations in more detail, read our article: When Do I Have To Take Medicare?
Should I Delay Medicare?
Even with creditable work coverage, you may still want to consider making Medicare your primary health insurance. Many people find Medicare can be more cost-effective or better cover their needs. Many factors determine what is best between Medicare and your work insurance. How much are the monthly premiums of each option? What are the yearly expected out-of-pocket costs and maximums? Which covers your doctors and prescriptions better? How many people in your family need coverage?
We recommend talking to a professional broker to make this decision. We here at NJ Life and Health have helped hundreds of people decide between the two, and we will always give you our unbiased expertise. If your work insurance is better, we will tell you.
If you’d like to learn more on your own time, read our article: Comparing Medicare to Work Insurance and Retiree Coverage
I Want To Delay Medicare
If your work coverage is better for your needs compared to Medicare, let’s discuss how to delay it! There are a few different methods, and we will go through each along with what to expect.
Applying Online
The best method to delay Medicare is to be proactive and sign up online. You can apply for Medicare online through your www.ssa.gov portal starting three months before your 65th birthday month. As you go through the application, you will get to a question: "Do you want to enroll in Medicare Part B?” If you are 100% sure you don’t want Medicare as your primary insurance at 65, click “No.”
This method will allow you to receive your Medicare card with just Part A. You will now have your Medicare number, making applying for Medicare Part B much easier when you are ready.
Sending Your Medicare Card Back
If you took Social Security before age 65, you may receive your Medicare card with Part A and B without signing up. This may also occur around your 65th birthday, even if you didn’t sign up, although we haven’t seen this quite as often in recent years. You will not receive your Medicare card automatically if you elect Social Security after age 65.
If you have decided to delay Medicare Part B, you can send your Medicare card back in the mail. Sign the back of your Medicare card and mail it to the address in the Medicare welcome packet. Once Social Security receives your card, they will send you a new Medicare card with the same Medicare number but only list Medicare Part A.
If you are planning on delaying Medicare and get your Medicare card in the mail with only Part A, you are in luck! You don’t have to do anything until you are ready to apply for Part B.
How To Take Medicare After Delaying It
After delaying Medicare, you may lose your creditable work coverage due to retirement or being laid off. In either situation, you are given a Special Enrollment Period to take Medicare Part B at any time of year. This Part B enrollment period lasts 8 months from the date you lose coverage, but you are given only 63 days to enroll in a drug plan. It can be confusing, so we recommend doing everything at once if possible.
To enroll in Medicare Part B after 65, you need 2 forms: CMS 40B and CMS L564. Both are available with a simple Google search, but for your convenience, we'll link them below. CMS 40B is your Part B application. It requires basic information, such as your contact details and Medicare number. You must also put the date you’d like Part B to start in the “Remarks” section.
CMS L564 is the Request for Employment Information form. This form lets Medicare know you have had legitimate work insurance the entire time you delayed Medicare. It will validate your Special Enrollment Period and allow you to avoid any penalties you otherwise would have accumulated. You must give it to your employer to fill out and sign.
CMS 40B: https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf
CMS L564: https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms-l564e.pdf
When you get these forms, you will want to drop them off at your local Social Security office. You can also fax them to your local Social Security office or upload them to your ssa.gov portal, but these options are not quite as reliable as of right now. Once everything is processed, you will receive a new Medicare card. It will have the same Medicare number and Part A date, but it will now have a Part B date as well.
You may receive your Medicare card or confirmation of Part B being processed after your scheduled Part B date. Getting a new Medicare card can take anywhere from 2 weeks to 2 months, so you’ll want to submit your paperwork as soon as possible. You may still be covered if you are at your Part B date and still haven’t received your card. If you submit all your paperwork before your Part B date, everything should be able to be backdated. You can even sign up for Medicare Supplements, Medicare Drug Plans, and Medicare Advantage Plans.
What If I Never Received Part A?
Many people at 65 don’t proactively sign up for Medicare Part A or receive their Medicare card. If you don’t have Part A when you’re about to retire, you’ll have to apply for Medicare online AND give some forms to Social Security. Fill out the Medicare application on ssa.gov for both Parts A and B, and then complete CMS L-564 (Request for Employment Information) and give it to your local Social Security office.
Summary
If you are confident your work health insurance is better than Medicare, you can delay Medicare until you are ready! You will want to be proactive in signing up for Part A and telling Medicare you don’t want Part B. When the time comes and you lose your work insurance, you can submit some basic paperwork to Social Security to get Part B.
This whole task can seem daunting, and we are happy to help! If you’d like help delaying Medicare and signing up later, our brokers can guide you. We have helped thousands of people just like you. Contact our Toms River, NJ office at 848-226-6897 or visit our website at www.njlifeandhealth.com.