Do I Sign up for Medicare if I am Covered By My Spouse’s Insurance?

Most people become eligible to enroll in Medicare insurance at age 65. This includes eligability for Medicare Part A, Part B, Part D, and Medicare Supplement Insurance (Medigap). While many people enroll in Medicare at this time, it may not be necessary if you are covered by your spouse’s employer-provided health care plan.

If you are eligible for Medicare, but already have coverage under your spouse’s insurance plan, you can:

  • Enroll only in Medicare Part A.
  • Enroll in Medicare Parts A, B, and D, and in Medicare Supplement plans.
  • Delay your enrollment until you are no longer covered under your current health insurance.

Before you decide what to do, it’s best to speak with your insurance provider to gain a better understanding of how your current insurance coverage works (or doesn’t work) with Medicare. Below, we’ll talk about the options you have when you turn 65 and are covered by your spouse’s health insurance plan.

Enrolling in Medicare Part A at age 65

Most Medicare Part A beneficiaries do not have a premium. For this reason, many choose to enroll in Part A while they still have primary insurance coverage through their spouse. Others choose to delay Medicare enrollment altogether. If you only enroll in Medicare Part A during your Initial Enrollment Period (IEP), you will need to ensure your health insurance has creditable coverage to avoid penalties when you enroll in Medicare Part B and Part D later.

If you choose to enroll in Medicare Part A when you turn 65 and have a Health Savings Account (HSA), you must discontinue contributing to your HSA prior to enrolling in your Medicare coverage. Contributions cannot be made to an HSA after someone is enrolled in Medicare.

Delaying enrollment in Medicare

You do not necessarily have to enroll in Medicare during your IEP. If you plan to delay until your spouse retires or loses his or her health insurance, it’s important to follow the rules to avoid future penalties and fees.

Those who are eligible to delay enrollment will not be penalized. You will have the opportunity to enroll in Part A, Part B, and Medigap within eight months of losing your coverage under your spouse’s health insurance plan – this is called a Special Enrollment Period.

Do I have to give notice to delay Medicare?

If you are already a recipient of Railroad Retirement Board or Social Security Retirement benefits, you will automatically be enrolled in Medicare Parts A and B at the age of 65. If you plan to delay Part B, you will need to contact the Social Security Administration to keep from being automatically enrolled in Part B. However, you must have Medicare Part A if you are a recipient of Social Security benefits.

If you do not receive Social Security or Railroad Retirement benefits, you do not have to provide any notice of your intent to delay your enrollment in Medicare.

Avoid penalties for delaying enrollment in Part B and Part D

To avoid penalties for delaying your enrollment in Medicare, you should do the following things:

  • Check to make sure that your coverage is creditable and that you qualify for delaying your enrollment by comparing your coverage to Medicare’s offerings.
  • Ask your current health insurance provider to give you documentation showing that your prescription drug coverage is creditable.
  • Enroll in Original Medicare and Medigap within eight months of terminating your employer-provided coverage.

As long as these requirements are met, you can plan to avoid future fees and penalties when delaying your Medicare enrollment.

What is creditable coverage?

To avoid Part B and Part D premium penalties, you will need to provide documentation that you have creditable health and prescription drug coverage. Coverage is only considered creditable if it provides at least the same coverage as Medicare Part B and Medicare Part D. If your coverage is not considered creditable, you should enroll as soon as you’re eligible for Medicare. If you don’t, you may experience additional fees on your premiums when you do enroll at a later date.

Aging into Medicare opens up a variety of options for your health care coverage. While it can feel overwhelming, we want to help you feel confident in your coverage decisions. To compare plans or learn more about your options, visit our Plan Comparison tool or call one of our Licensed Medicare Advisors at 1-855-665-9200.

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