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If you have health insurance through your spouse’s employer, you may not need to sign up for Medicare at 65. The answer often depends on the size of the employer.
Let’s say your spouse works for a large employer, considered a company with 20 or more employees; in this case you don’t need to sign up for Medicare at 65. The company-sponsored health insurance will continue to be what pays medical bills first, as the primary payer. Medicare will be the secondary payer.
Employers with 20 or more employees must offer the same health benefits to all employees and their spouses regardless of age and they can’t require you or your spouse to enroll in Medicare at age 65.
But if your spouse works for an employer with fewer than 20 employees, Medicare typically becomes the primary coverage at age 65 and the employer coverage is secondary. In that case, you need to sign up for Medicare at 65 or else you may face gaps in coverage.
You won’t have to pay a late enrollment penalty if you enroll in Medicare within eight months of losing that coverage.
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Should I enroll in Medicare Part A?
Even with employer coverage, many people turning 65 enroll in Medicare Part A. You won’t have to pay premiums if you or your spouse has paid Medicare taxes for 40 quarters or more, the equivalent of 10 years’ work. If you’re qualifying for Medicare through your spouse, you have to be married at least one year before applying.
Some people who work for large employers delay enrolling in Part A while working so they can contribute to a health savings account, because you can’t make new HSA contributions after enrolling in Medicare Part A or Part B.
More on Medicare
I Turn 65 Soon. When Should I Sign up for Medicare?
It depends on whether you or your spouse is still working
5 Steps to Help You Sign Up for Medicare Benefits
When to enroll and what decisions you need to make
Understanding Medicare’s Options: Parts A, B, C and D
Making sense of the alphabet soup of health care choices