Do I need to decline Medicare at 65 if I want to keep my employer insurance?

You're asking a really common question! If you're already receiving Social Security benefits, then yes, you'll be automatically enrolled in Medicare Part A and Part B when you turn 65. If you're not yet taking Social Security, you won't be automatically enrolled. Since you want to keep your employer coverage, here's what you need to know: 1. Medicare Part A (hospital insurance) is free for most people and you might want to take it even with employer coverage 2. Medicare Part B (medical insurance) requires a monthly premium, which you probably don't want to pay if you have good employer coverage If you're not yet on Social Security benefits, you don't need to do anything to decline. If you are on benefits and will be auto-enrolled, you should contact SSA to decline Part B (you'll fill out Form CMS-1763). Important: Make sure your employer has 20+ employees. If they do, you can delay Medicare enrollment without penalty while covered by that employer plan.

Ugh, I had such a NIGHTMARE with this exact situation last year! Be really careful because NO ONE at my company HR warned me that Medicare would automatically enroll me even though I didn't want it!!! I was already getting SS retirement and suddenly Medicare premiums started coming out of my check without warning. Then I had TWO insurances and all my doctors were confused about which one to bill. TOTAL MESS that took me 4 months to fix!!!!

The previous responses are mostly correct, but I want to clarify a few important technical details about Medicare enrollment at 65 when you have employer coverage: 1. If your employer has 20+ employees, your group health plan is the primary payer and Medicare would be secondary. This is called the MSP (Medicare Secondary Payer) rule. 2. You qualify for a Special Enrollment Period (SEP) when your employer coverage eventually ends, giving you 8 months to enroll in Medicare without penalties. 3. While Part A is premium-free for most people, there's one situation where you might NOT want to take Part A: if you're contributing to an HSA. Medicare enrollment disqualifies you from making HSA contributions. 4. When you do eventually enroll, you'll need your employer to complete form CMS-L564 (Request for Employment Information) to prove you had creditable coverage. This information is accurate as of 2025.

Just my quick 2 cents - I kept my employer insurance when I turned 65 last year and it was totally fine. Didn't have to do anything special. But maybe double check w/ your HR if there are any changes to your premium or coverage once you turn 65? My company actually gave me a small discount once I hit 65 which was a nice surprise!

Argh this whole system is SO FRUSTRATING. Why can't they just make this simple?? I've been dealing with my mom's Medicare issues for months and nobody gives straight answers. Every person at SSA tells you something different. Good luck!

hey i think u might be overthinking this! if ur not on SS yet then they dont automatically sign u up for medicare. just keep ur work insurance and ur good! thats what i did and had no issues

There's one important detail I don't think anyone has mentioned yet. If your employer has fewer than 20 employees, Medicare becomes primary and your group health plan becomes secondary at 65, even if you don't enroll in Medicare. This means your group plan may not pay claims if they determine Medicare should have paid first. You mentioned your employer is larger than 20 employees, but I wanted to clarify this point since it's a common misunderstanding. With large employers (20+ employees), you can safely delay Medicare without penalties while maintaining your current coverage. When you do eventually leave your employer coverage or retire, remember you'll have an 8-month Special Enrollment Period to sign up for Medicare without penalties. Don't miss this window - I've seen many clients face lifetime penalties for late enrollment.

One last tip based on what you've shared so far: since you're planning to wait until 70 to claim Social Security but will be retiring before that, make sure you contact SSA about 3 months before you lose your employer coverage to initiate your Medicare enrollment. They'll need to verify your employment history and process your application, which can take some time. When that time comes, have ready: - Your birth certificate - Tax records or W-2s from the previous year - Information about your employer insurance - The dates your coverage began and will end Thinking ahead will make that transition much smoother!