Here are some questions commonly heard at On Point Insurance Agency (InsuranceOnPoint.com) about Medicare enrollment:

Do I have to start Medicare when I turn 65? – In certain circumstances the answer is yes. First, if covered through the Affordable Care Act, the eligibility for the Advance Premium Tax Credit ends when eligibility for Medicare begins. Paying full price for a plan through the ACA would always be more expensive than Medicare premiums. Only individuals with eligible immigration status who have not yet qualified for Medicare by living here for five years may get ACA tax credits over the age of 65.

Second, you are required to begin Medicare if currently employed where there are fewer than 20 employees. Employer coverage can be used in addition to Medicare to cover the gaps of Original Medicare (Part A and Part B), but Medicare is primary and the employer plan will be secondary.

Can I keep my coverage through my employer after age 65? – Yes. If there are more than 20 employees the employer plan will pay first instead of Medicare. In this instance, it is possible to start Part A only and continue with employer coverage and there will be a coordination of coverage between the two. Part B can be added later when leaving the employer plan. When starting Part B after the age of 65, Medicare will require proof of employer coverage.

I’ve heard there are Medicare penalties in the future if I don’t enroll right away? – The Late Enrollment Penalties to avoid are for both Part B (medical) and Part D (prescription drug coverage).

There is an 8-month Special Enrollment Period after leaving an employer’s plan to enroll in Part B without penalty. Beyond this eight-month window, enrollment in Part B is only allowed annually during the General Enrollment Period of January 1st – March 31st. There is also a cumulative Part D penalty that begins to accrue on a monthly basis after 63 days of leaving an employer plan which will be assessed when a Part D plan is chosen later.

Can I keep COBRA after age 65 so my younger spouse can have coverage? – No. COBRA is not considered creditable coverage by Medicare so penalties will be assessed accordingly when enrolling in Medicare. A spouse still needing coverage could choose to enroll in the ACA Marketplace or find an ACA alternative plan while the employee enrolls in Medicare.

Let the licensed health insurance agents at On Point help you navigate the road from employer coverage to Medicare!