Do I Need Medicare if I’m Covered by My Spouse’s Employer Plan?

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If you are turning 65 and are eligible for Medicare, but covered by your spouse’s employer plan, it may not seem like a logical idea to enroll in Medicare when you’re already covered. However, you do have some options to consider if you are facing this situation.

Delaying Medicare Coverage

You do have the option to delay your enrollment for Medicare if another health insurance plan already covers you.

For some, delaying enrollment can lead to permanent penalties and fees when they finally enroll in Medicare. However, you can avoid these penalties by following the guidelines laid out by Medicare:

  • You need to have creditable coverage
  • You need to have creditable prescription drug coverage and need written proof

If you decide to delay enrollment and keep your spouse’s employer plan coverage until your spouse retires, when you lose the coverage, you can enroll during a Special Enrollment Period. The Special Enrollment Period can give you a 60-month window before or after your loss of coverage to enroll in Medicare without penalty, as long as you meet the requirements.

During the Special Enrollment Period, you can enroll in Medicare Part A and Part B and a Medicare Part D prescription drug plan.

Enrolling in Medicare

If you do not want to delay your Medicare enrollment process, you can still enroll in Original Medicare, a Medicare Advantage Plan, or a Medicare Part D prescription drug plan. You will need to enroll during your Initial Enrollment Period, which begins three months before your 65th birthday and ends three months after your 65th birthday.

You can also enroll in Medicare Part A, and delay your enrollment for Part B and Part D. Some choose to enroll in Part A as it can be premium-free if you receive Social Security benefits. If you decide to delay enrollment for Part B and Part D, you will need to provide proof of having creditable coverage so you can keep clear of penalties for when you do enroll in both.

Should I enroll in Medicare?

Enrolling in Medicare when you already have health coverage is not necessary, but if you don’t want to delay your enrollment, then you should familiarize yourself with the enrollment periods to avoid possible penalties.

If you have any questions regarding the Medicare Enrollment Periods, we welcome you to give us a call at 662-844-3300 or send us a message through our online form and one of our helpful licensed Medicare insurance agents will get back with you.

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Justin Brock

President & CEO of Bobby Brock Insurance