Health Insurance Options If You Are Waiting To Become Medicare Eligible

When you become eligible for Medicare at 65, you are able to have access to many health insurance options.

However, what options are available to you at age 64? 

Employer coverage

If you are nearing the end of your employment and retiring by age 65, you may have employer coverage before enrolling in Medicare.

This can be through a spouse or your own workplace. It provides you with the minimum essential coverage which includes coverage for doctor visits, prescriptions, and hospitalization, all of which are covered under Medicare.

If you are still working past age 65, don’t worry, you can still have coverage in 2 ways.

Keep employer coverage, but elect Medicare Part A

Once you become eligible for Medicare, you can choose to keep your employer plan and only partially enroll in Medicare. Here is how it would work:

If you still plan on working beyond 65, you would only enroll in Medicare Part A (hospitalization) when you turn 65 and remain on your employer coverage. 

If you do take this route, you will need to provide proof of credible drug coverage, which is usually included in employer plans. 

Then, once you retire or lose your employer coverage, you will have 8 months to apply for Medicare Part B (medical), Part D (drug), and any other products.

Taking these steps will activate your Medicare Part A and when you retire you can complete the Medicare enrollment process in other Medicare plans.

Please note, this can only be done if your company has 20 or more employees. If your company has less than 20 employees or you are self-employed, then you must enroll in Medicare at this time.

Delay both Parts A and B and enroll another time 

It is possible to skip the Medicare enrollment process once you turn 65. However, you are only eligible to do this if your company has 20 or more employees. 

You will have 8 months to enroll in both Medicare Part A and B once you are ready to retire or lose employer coverage. In this case, you will be asked to provide paperwork proving you had credible coverage, including drug coverage that must be submitted with your application. 

This is considered a Special Enrollment Period, and once you get your Medicare card you can enroll in Part D and other products such as Medicare Advantage or Medicare Supplement.

ACA Plan

The other route you can take to have coverage before turning 65 is an ACA plan through the marketplace/ state exchange. You can enroll in this plan during Open Enrollment or if you have a life-changing event.

These plans can include your family members, and once you become Medicare eligible, they will remain on the plan and the price may be subject to change.

Private Plan

Some states offer private health insurance plans that can be enrolled in from 3-36 months. This can be a good option because you can tailor the coverage to include the amount of time you have until you become eligible for Medicare.

Check with your state and your broker to make sure you qualify for this option, as it is not available to everyone.

Whether you turn 65 next month or next year, it is important to know your health insurance options. Contact me today for a free consultation.