Q. I’m turning 65 later this year. I still work and have health insurance through my employer. I know there can be penalties for signing up late for Medicare. How does this work and what do I need to do?
— Still 64
A. Medicare can be complex, so we’re glad you asked.
It’s time to take a closer look at your employer and how many employees are covered under your group plan at work.
Medicare beneficiaries are exempt from any penalties if they are participating in an employer group health plan with 20 or more covered employees, said Geraldine Callahan of Callahan Financial Services in East Hanover.
“You may or may not have to get on Medicare,” she said. “This would depend on your company rules.”
She said you should speak to your human resources or benefits manager.
If you are not required to go on Medicare, she said, you can continue participating in your group plan and maintain status quo.
“Upon retirement or when you decide to leave the group plan, you will have an opportunity to enroll in Medicare without any penalties provided you can show proof that you have had credible health coverage equal to Medicare’s coverage,” Callahan said. “During that time you can select a Medicare supplement, Part D and Medicare Advantage plan.”
If your employer requires you to sign up for Medicare Part A & B, you will need to know if your employer will allow you to participate in the group health plan, she said. The group plan would become primary, and Medicare would be the second payer.
“When you leave the group plan, you will have a Special Enrollment Period that will last for eight months,” she said. “However, the period for enrollment in a Part D plan and a Medicare Advantage plan is only 63 days.”
You may also decide to forgo the group plan altogether and sign up for an individual supplement plan, she said, so you should do a cost and coverage comparison.
Callahan said most workers will consider adding Medicare Part A because it is free. It covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and provided in hospices, she said.
“If your employer group plan is a high-deductible health plan paired with a health savings account, you should not sign up for Part A,” she said. “Once you enroll in Medicare, your HSA contributions must stop.”
Email your questions to moc.p1524215369leHye1524215369noMJN1524215369@ksA1524215369.