Turning 65 in 2020
If you were born in 1955, you will be eligible for Medicare in 2020. Eligibility for Medicare begins on the first day of the month in which someone turns 65. There is a difference between “eligible” and “enrolled.” A U.S. citizen aged 65 or older usually qualifies for Medicare. One of the eligibility criteria is that the person or spouse must have worked in the U.S. and paid Medicare taxes for a minimum of 40 calendar quarters.
Each person that becomes eligible for Medicare needs to determine whether to enroll at age 65 or defer enrollment to a future date. Deferment may be available if you have access to other health insurance benefits that are considered “creditable coverage” by Medicare. Examples may include employer provided health insurance, retirement plans, and government programs such as VA or TriCare. Individual health insurance plans and Marketplace coverage through healthcare.gov are typically not available to those who are 65 or older.
When deferring your enrollment in Medicare is an option, the next step is to compare the costs and healthcare coverage of your current coverage and Medicare. Those who continue to work beyond age 65 and are eligible to participate in an employer sponsored health plan can choose which option is best. If you choose to stay on the employer plan, you have an ongoing choice to move to Medicare.
Frequently, an employee will continue the employer plan beyond age 65 to provide health insurance for younger family members. The fact that an employee becomes eligible for Medicare is NOT a qualifying event that gives family members the right to enroll in COBRA. COBRA is offered when an employee has lost eligibility for the employer benefits due to voluntarily leaving the position (like retirement) or a reduction in work hours. If the employee stays on the job and continues to be eligible for the employer plan, no COBRA will be available when the employee chooses to enroll in Medicare.
Medicare and Social Security are frequently confused. Both are federal programs designed to assist older Americans and those with disabilities. Social Security provides financial support. Medicare is a health insurance program. For many years, eligibility for both programs occurred at age 65. Full social security benefits are now earned later. Someone born in 1955 will reach full retirement age for social security purposes at 66 years and two months. Your choice of when to enroll in Medicare and when to enroll in Social Security are two separate decisions.
Everyone has questions about Medicare. It’s mostly due to fear of the unknown. It’s critical to get your answers early in the process so that you can make timely and informed decisions that will avoid costly mistakes. My primary role is to educate. Once someone understands what the options are, they feel empowered to make those choices.