Wife turning 65. Need to enroll in medicare?

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dave1054
Posts: 80
Joined: Wed Apr 01, 2009 7:50 am

Wife turning 65. Need to enroll in medicare?

Post by dave1054 » Thu Aug 16, 2018 7:16 pm

We have good company insurance in 10 employee physician practice. I will be working a few more years. Wife turning 65 in February. Does she need to enroll in medicare and if so, can she keep our company insurance. When I turn 65 in October, can we both take medicare and get reimbursed by company?

Jefferson
Posts: 46
Joined: Wed Feb 21, 2018 1:37 pm

Re: Wife turning 65. Need to enroll in medicare?

Post by Jefferson » Thu Aug 16, 2018 7:26 pm

I have zero official knowledge of this. But my understanding is this.

She doesn’t have to come off your private insurance, but there’s no point in staying on it bc all private insurance policies are secondary to an available government insurance claim.

I’m not aware of any law that would prevent an employer from reimbursing you for Medicare premiums, but that might be a tough sell to your company.

InMyDreams
Posts: 350
Joined: Tue Feb 28, 2017 11:35 am

Re: Wife turning 65. Need to enroll in medicare?

Post by InMyDreams » Thu Aug 16, 2018 8:26 pm

I am not an expert - not even close. Hopefully someone who is will chime in.

But special rules apply to small employers. Take a gander at this article
http://www.investmentnews.com/article/2 ... -employees

You may also want to look up creditable plans
https://medicare.com/resources/medicare ... -coverage/

ResearchMed
Posts: 7073
Joined: Fri Dec 26, 2008 11:25 pm

Re: Wife turning 65. Need to enroll in medicare?

Post by ResearchMed » Thu Aug 16, 2018 8:29 pm

Jefferson wrote:
Thu Aug 16, 2018 7:26 pm
I have zero official knowledge of this. But my understanding is this.

She doesn’t have to come off your private insurance, but there’s no point in staying on it bc all private insurance policies are secondary to an available government insurance claim.

I’m not aware of any law that would prevent an employer from reimbursing you for Medicare premiums, but that might be a tough sell to your company.
I don't think this is correct.

Doesn't it depend upon, at least in part, the size of the Employer?
For the larger Employers (not sure minimum # employees...20? 50?), one (or spouse) stays ON the Employer plan for health care at age 65, but one signs up for Part A.

I don't know what happens if one doesn't sign up for Part A. Is there a penalty now or later, like the penalty for delayed signing up for Part B?
Our Employer required it at 65, so we just "did it".

RM
This signature is a placebo. You are in the control group.

Katietsu
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Joined: Sun Sep 22, 2013 1:48 am

Re: Wife turning 65. Need to enroll in medicare?

Post by Katietsu » Thu Aug 16, 2018 9:35 pm

I am hoping someone more knowledgeable comes along. However, I believe that since your employer plan involves less than 20 employees, the group plan would be secondary to Medicare. Consequently, you would need to enroll in Part A and Part B (maybe Part D too) within about 7 months of turning 65 or face a lifetime delayed enrollment penalty. Then, once you sign up for Part B, the next 6 months is your Medigap enrollment period that allows you to sign up without underwriting.

It seems like it would be best if you went off the company plan and on to Medicare given the small employer rules. You can keep the company plan too but it seems like it would mean a lot of overlapping coverage or potentially setting yourself up for problems once you do retire. I know others who have negotiated an increased salary with a small employer since they had other health insurance coverage. I do not know if the ACA has any rule against this.

As I am sure you know, health insurance is quite complex, so I would thoroughly investigate the options before your wife turns 65.

InMyDreams
Posts: 350
Joined: Tue Feb 28, 2017 11:35 am

Re: Wife turning 65. Need to enroll in medicare?

Post by InMyDreams » Thu Aug 16, 2018 9:45 pm

ResearchMed wrote:
Thu Aug 16, 2018 8:29 pm
Doesn't it depend upon, at least in part, the size of the Employer?

RM
^^ this. please read the article

and from the CMS's fact sheet, page 3:
"After I retire, I will have HEALTH COVERAGE FROM A SPOUSE who is still
working AND his/her employer has fewer than 20 employees.
If you will have health coverage through a spouse and his/her employer or union
has fewer than 20 employees, you should enroll in both Part A and Part B. In this
case, Medicare pays before the employer insurance. This means that Medicare is
the primary payer for your health coverage."


https://www.cms.gov/Outreach-and-Educat ... irment.pdf
Last edited by InMyDreams on Thu Aug 16, 2018 11:46 pm, edited 2 times in total.

wanderer
Posts: 93
Joined: Sat Aug 16, 2014 4:09 pm
Location: Houston, Texas, USA

Re: Wife turning 65. Need to enroll in medicare?

Post by wanderer » Thu Aug 16, 2018 10:42 pm

I hope you have found this booklet from the SSA. the situation you describe appears to be on page 11..
https://www.ssa.gov/pubs/EN-05-10043.pdf.

We face the transition in 2019, with DW a few months senior. We are currently on megacorp's pre-65 retiree plan. We were told by megacorp that DW signs up for Part A before age 65 which then becomes effective the birthday month (or month after). Then when I turn 65 and sign up we both switch to the part B/D sections as primary, with our company supported supplemental as secondary. This seems consistent with the SSA booklet.

Suggest you contact your current plan sponsor to get the specifics.

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