Should I Delay Medicare Enrollment if I Have Employer-Sponsored Insurance?
If you still have employer-sponsored health insurance coverage through your or your spouse’s employer when you turn 65, you can delay Medicare enrollment without penalties. Whether your employer-sponsored coverage will pay primary or secondary, will determine if it might still be in your best interest to enroll in Medicare. Most of the time, you should delay Medicare Part B enrollment only if your employer-sponsored coverage is the primary payer.
Which Coverage is Primary?
It will be the primary payer if your employer-sponsored coverage is from an employer with more than 20 employees. This means that Medicare will be secondary, and delaying enrollment in Medicare Part B might be beneficial to avoid an additional monthly premium.
Medicare will be the primary payer if your employer-sponsored coverage is from an employer with less than 20 employees. This makes employer-sponsored coverage secondary. Your employer-sponsored coverage may not provide much coverage if you delay enrollment in Medicare Part B. In this case, it’s usually best to enroll in Medicare Part B to avoid high out-of-pocket costs for care.
Enrolling in Medicare After Delaying Enrollment
When it comes time to enroll in Medicare after delaying enrollment, ensure you have kept proof of enrollment for your employer-sponsored coverage. You will be eligible for a Special Enrollment Period to enroll in Medicare once you no longer have employer-sponsored coverage. Still, you will need proof of enrollment from your employer-sponsored coverage. Proof includes:
- Written notice from your employer/plan
- Documents that show health insurance premiums were paid
- Pay stub
- Tax returns
- Health insurance cards with relevant effective dates
Notes: There are different rules for those who became Medicare eligible due to a disability or ESRD. There are also separate rules for those who have COBRA or retiree insurance.