Do I Need Medicare?

Is your 65th birthday approaching? If so, Medicare might be on your mind. We get hundreds of questions about Medicare every week, but almost everyone begins with the same question. Do I need Medicare?

The short answer is yes, but not everyone’s Medicare experience will be the same. You can choose to delay your enrollment past the age of 65, and there are also several different kinds of Medicare plans to choose from. 

Medicare Enrollment Timeline

Most people become eligible for Medicare when they turn 65. Younger individuals can also be eligible for Medicare if they meet certain criteria, such as being on disability for two years or being diagnosed with Lou Gehrig’s disease. For our purposed, we’re going to focus on those who “age into” Medicare.

People who want to enroll in Medicare as soon as they are able should submit their application prior to the month of their 65th birthday. You’ll have what’s called an Initial Enrollment Period, which begins three full months before your birthday month. If you enroll during one of those three months, your benefits can begin on the first day of the month of your birthday.

What some people don’t realize is that you can delay Medicare enrollment in certain situations. Anyone can postpone enrollment, really, but you want to make sure you won’t incur any late enrollment penalties if you decide to wait.

We’ve been seeing lots of people work past the age of 65. In many of those cases, they’ve had access to an employer-sponsored group health plan. And, since some employers help pay plan premiums, it can often be more cost-effective to stay on that plan. We even encourage you to do this if it makes the most financial sense. The catch here is that the plan must be creditable. 

“Creditable” means that the plan offers at least as much coverage as Parts A and B of Medicare. Employers who have at least 20 employees always have creditable coverage. If that applies to you, then yes, you can delay Medicare with no penalty. If you have a smaller employer, you’ll need to find out if your insurance policy is creditable for Medicare. You can ask your HR director or call the carrier yourself. In either case, be sure to verify this before deciding to postpone Medicare enrollment.

People who have creditable coverage may put off Medicare enrollment as long as they have that plan in place. Once they decide to terminate coverage, they’ll be granted a Special Enrolment Period to switch to Medicare.

Decide If Medicare Is Right for You

We’ve barely scratched the surface on things to consider when answering the question, “Do I need Medicare?” Call the team at Local Medicare Specialists and we can help you decide when you should enroll in Medicare and which plans might be best for your situation.