By Betty Berry, Tuesday, June 21, 2011  Q: I am about to turn 65 and had planned to enroll in Medicare, however, a friend told me that since I was going to continue working I shouldn’t enroll until I quit working. Can you explain how my continuing to work has any effect on when I should sign up?

A: Your question is one that many struggle to understand and your friend’s advice could be correct or incorrect depending on your particular situation.

First you must understand that Medicare consists of several parts. Part A is hospitalization coverage, Part B is medical coverage and Part D covers prescription drugs.

Medicare Part A comes to most Medicare beneficiaries with no monthly fees. All beneficiaries should sign up for this coverage when they turn 65.

Medicare Part B covers doctors’ services, lab fees, etc. It comes with a price tag. There is a monthly premium for this coverage. Whether you should sign up for Part B coverage depends on whether you or your spouse plan to continue working and receive health care coverage through an employer.

If the company you or your spouse are working for has fewer than 20 employees you must sign up for Medicare Part B. Medicare will be your primary coverage and any insurance provided by your employer would then become secondary coverage.

If you are 65 or older, or if you have a spouse of any age, who is working and either your or your spouse’s employer has 20 or more employees and that employer offers health insurance you have a choice.

This rule also applies if you or your spouse is self-employed and covered by a plan through connection with a firm that has 20 or more employees.

You may accept or reject any employer’s plan that is offered. If you accept the plan it will be your primary health care coverage. You can enroll in Medicare Part B if you wish. It would become a secondary coverage for some expenses.

Whether you wish to enroll in Medicare Part B will depend on how fully the employer plan covers doctors and health services. You would also need to consider whether the secondary benefits Medicare Part B would provide would be worth the monthly cost to you. Medicare Part B monthly premium for 2011 is $115.40.

If you choose to reject the employer’s plan then you most certainly should enroll in Medicare Part B and it will be your primary health care coverage. If you make this choice the employer plan cannot become a supplemental plan to Medicare. If you feel you need additional protection to cover what Medicare doesn’t cover you must then consider purchasing a “medigap” policy.

You can, if you wish, also keep the employer’s plan if it offers coverage for non-Medicare covered items such as hearing aids, vision tests and glasses and routine dental care. Again you will want to consider the cost, if any.

Medicare Part D, the newest Medicare coverage, covers prescription drugs. A beneficiary who has enrolled in Part A and/or Part B is eligible for this coverage. If you opt for an employer’s plan and it has prescription drug coverage that is equal to or better than Part D coverage you do not need to enroll in a Part D plan.

As long as you or your spouse continue working for an employer who has 20 or more employees and are covered by an employer’s plan you can postpone enrollment in Parts B and D until you stop working or the employer discontinues that coverage. At that time you have a special enrollment period to enroll in Medicare Parts B and D without penalty.

I hope that helps a little in helping you decide.


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