Do I need to sign up for Medicare when I turn 65?

It depends on how you get your health insurance now and the number of employees that are in the company where you (or your spouse) work.

Generally, if you have job-based health insurance through your (or your spouse’s) current job, you don’t have to sign up for Medicare while you (or your spouse) are still working. You can wait to sign up until you (or your spouse) stop working or you lose your health insurance (whichever comes first).

  • If you’re self-employed or have health insurance that’s not available to everyone at the company: Ask your insurance provider if your coverage is employer group health plan coverage (as defined by the IRS.) If it’s not, sign up for Medicare when you turn 65 to avoid a monthly Part B late enrollment penalty .
  • If the employer has less than 20 employees: You might need to sign up for Medicare when you turn 65 so you don’t have gaps in your job-based health insurance. Check with the employer.
  • If you have COBRA coverage: Sign up for Medicare when you turn 65 to avoid gaps in coverage and a monthly Part B late enrollment penalty. If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up. If you're eligible for Medicare, you don't qualify for COBRA coverage without having to pay a premium.

Answer a few questions to find out when you need to sign up.

How do I sign up for Medicare?

If you’re already getting benefits from Social Security (or Railroad Retirement Board), you’ll automatically get Medicare. If not, you’ll need to sign up.

Find out how you get Medicare based on your situation.

How does Medicare work with my job-based health insurance?

Keep in mind that:

  • Most people qualify to get Part A without paying a monthly premium.  If you qualify, you can sign up for Part A coverage starting 3 months before you turn 65 and any time after you turn 65 — Part A coverage starts up to 6 months back from when you sign up or apply to get benefits from Social Security (or the Railroad Retirement Board).
  • If you have a Health Savings Account, you and your employer should stop contributing to it 6 months before you sign up for Part A (or apply to start getting Social Security benefits) to avoid a tax penalty.

I’m still working and…

How my coverage works with Medicare (Part A & Part B):

My (or my spouse’s) job has less than 20 employees.

  • Medicare pays for services first, and your job-based insurance pays second.
  • If you don’t sign up for Part A and Part B, your job-based insurance might not cover the costs for services you get.
  • Ask the employer that provides your health insurance if you need to sign up for Part A and Part B when you turn 65.

My (or my spouse’s) job has more than 20 employees.

  • Your job-based insurance pays first, and Medicare pays second.
  • If you don’t have to pay a premium for Part A, you can choose to sign up when you turn 65 (or anytime later).
  • You can wait until you stop working (or lose your health insurance, if that happens first) to sign up for Part B, and you won’t pay a late enrollment penalty.

I (or my spouse) get a stipend from my employer to buy my own health insurance.

OR

I (or my spouse) am still working, but I don’t have health insurance through that job.

  • Generally, Medicare doesn’t work with your insurance.
  • Once you sign up, Medicare pays first.
  • Some private insurance has rules that lower what they pay (or don’t pay at all) for services you get if you’re eligible for other coverage, like Medicare.
  • Ask your health insurance company if you need to sign up for Part A and Part B when you turn 65.

Do I need to get Medicare drug coverage (Part D)?

You can get Medicare drug coverage once you sign up for either Part A or Part B. You can join a Medicare drug plan or Medicare Advantage Plan with drug coverage anytime while you have job-based health insurance, and up to 2 months after you lose that insurance.

Even if you have a Special Enrollment Period to join a plan after you first get Medicare, you might have to pay the Part D late enrollment penalty. To avoid the Part D late enrollment penalty, don’t go 63 days or more in a row without Medicare drug coverage or other creditable drug coverage .

If you have other drug coverage: Ask your drug plan if it’s “creditable drug coverage.”

Each year, your plan must tell you if your non-Medicare drug coverage is creditable coverage. Keep this information — you may need it when you’re ready to join a Medicare drug plan.

If you:

Do this:

Don’t have any drug coverage

  • Join a Medicare drug plan or Medicare Advantage Plan with drug coverage within 3 months of when your Medicare coverage starts to avoid a monthly Part D late enrollment penalty .

Have drug coverage that’s creditable

  • You can wait to get Medicare drug coverage (Part D).
  • If your drug coverage switches to ‘not creditable,’ you’ll have 2 months to join a Medicare drug plan. You won’t get the Part D late enrollment penalty as long as you don’t go more than 63 days without creditable drug coverage.

Have drug coverage that’s not creditable

  • Join a Medicare drug plan or Medicare Advantage Plan with drug coverage within 3 months of when your Medicare coverage starts to avoid a monthly Part D late enrollment penalty.
  • If your other drug coverage just switched to ‘not creditable,’ you’ll have 2 months to join a Medicare drug plan or Medicare Advantage Plan with drug coverage. You won’t get the Part D late enrollment penalty as long as you don’t go more than 63 days without creditable drug coverage.

Get more details on how Part D works with other insurance.

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