medicare why

[e823256l]

i  i turn 65 in two months. i am fully employed and plan on working another year and not taking social security until then. I am currently covered by my wife's employer insurance which is really good and reliable. anyway, we don't plan on leaving this situation for another year. everyone says i should enroll in part a but I am concerned that if i do our insurance will question why i am not using it. I don't want to call attention to this and would rather not opt for medicare at all at this time (because I expect the benefits to be greatly reduced OR the employer would question my participation and drop me and/or us). any pointers? 

thanks

e.s.l. 

[papawofboo]

Ok, take the Medicare insurance, if you don't take it at 65 you may pay a fee later on. Your employee insurance is the main one and will be filed first. It will never know or need to know you have MC.

Medicare will most likely pick up all of the balance of any claims. I had an advantage plan, so it picked up the balance on Dr. visits, lab/test and meds.

[GailL1]

@e823256l 

As long as your wife’s employer plan is Group Employer Coverage then you should have no problem.  

The number of employees they have also plays a part in the coordination of benefits between Medicare and employee coverage.

• - If they have over 20 employees, the Employer Group Coverage is the Primary.  
• If there are less than 20 employees, then Medicare is the Primary, employer plan is secondary and you may wish to sign up for all of Medicare so that the plans can work together.  Talk to HR or to the employer to verify that the coverage is primary to Medicare or IF it is secondary what coverage it requires you to take for Medicare.  
• There are also other rules if the employer is considered LARGE - over 100 employees.

1.  Sign up for Medicare Part A IF it is free of premiums for you ( that’s where your payroll taxes for Medicare have been going in all your years of work).  This is the Hospital portion of Medicare.  It will work with your Employer Group Coverage. 

2.  You can delay signing up for Part B and Part D as long as the Employer Group plan has 20 or more employees.  Less than that number, check with the employer or HR dept.There are also other rules if the company has more than 100 employees.

3.  When you get ready to sign up for the rest of Medicare after losing the Employer Coverage for whatever the reason. you will need to have the employer complete form CMS-L564 and return it to you.  You will complete form CMS-40B and submit them to Social Security Administration because they are the ones that handle Medicare sign ups.

4.  As long as you have these two forms completed when you enroll down the road whenever you loss employer coverage, you will have no problem and will not have to pay a late sign up penalty.  You will get a Special Enrollment period for doing this sign up and will not have to risk a gap in coverage. Once signed up, you pick your Medicare Plans and you are all set.

5. If you do NOT have these forms when you get ready to sign up down the road when you lose employer coverage then you will have to pay a late sign up penalty premium in addition to the regular premiums - so these forms are extremely important to proving your coverage while under employer coverage.

Some links for you -

Medicare.gov - Medicare while working past 65

Medicare.gov - Medicare’s Coordination of Benefits

The forms for when you need to sign up for Part B and Part D when you lose employer coverage

CMS.gov  Instructions for Signing Up for Medicare Part B during a SEP after losing Employer coverage...

THE FORM: CMS-L564 - REQUEST FOR EMPLOYER INFORMATION’

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THE FORM: CMS- 40B - Part B Application