Do I have to be retired to enroll in Medicare

The short answer: No, you do not need to be retired to enroll in Medicare.  

American workers that qualify for Medicare based on their employment record, can enroll in the program when they turn 65 years old—this isn’t dependent on if they are working or not working. Many non-retired Americans that are 65 years old need to enroll in Medicare, while others can wait until they do retire.

It is common that seniors over the age of 65 are retired, which makes it important for them to sign up for Medicare as soon as they reach the age of 65. However, it is not uncommon that seniors who are 65 are still in the workforce and have medical insurance through their employer. Seniors who are covered through a group health plan with an employer who employs 20 or more people and is credible coverage, generally do not need to enroll in Medicare.

While it is not a necessity to enroll in Medicare if you are covered by your employer, it is beneficial to enroll in Medicare Part A on time even with your employer’s health coverage. Doing so will not cost you any extra and Medicare will serve as a secondary insurance for you. This means that Medicare could potentially cover or partially anything that your primary insurance place does not cover for you.

  • Medicare Parts A and B: Medicare Part A covers inpatient hospital stays, skilled nursing facility care, nursing home care, hospice care, and home health care. Medicare Part B covers outpatient medical costs such as mental health services, preventative care, ambulance services, and others. These two parts make up Original Medicare, which the federal government provides.

If are already signed up for Social Security benefits, you will be automatically enrolled in Medicare Parts A and B starting in the month of your 65th birthday. If you haven’t, you will still need to apply for Medicare, which you can do on the Social Security Administration’s website. If you are still employed at 65 and you are not claiming Social Security benefits, the government will not automatically enroll you in Medicare Part A.

What will it cost?

Most people are not charged a premium for Medicare Part A. Typically if you or your spouse worked and paid into Medicare taxes for 10 years, you will not be charged a premium for Medicare Part A—this is referred to as “premium-free Part A”. However, if you or your spouse did not pay Medicare taxes long enough, you can still purchase Medicare Part A, but you may be subject to a monthly premium—this is referred to as “premium Part A”.

Regardless of employment history everyone will pay a premium for Medicare Part B. The premium for Medicare Part B will vary depending on the recipient’s income. Most people will pay the standard premium amount.

When can I enroll?

Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

  • If you sign up before you are 65 the coverage will begin the month you turn 65.
  • If you sign up the month you turn 65 the coverage will begin the following month.
  • If you sign up 1 month following your 65th birthday your coverage will start 2 months after you sign up.
  • If you sign up for Medicare 2 or 3 months after you turn 65, your coverage will start 3 months after you sign up.

In Summary

If Medicare will be your primary insurance, it is necessary that you sign up at 65, this is even if you’re still working. If Medicare would be a secondary form of insurance to your current insurance, it is not an immediate need, and you can prolong the process. You should review the numbers to see what financially makes the most sense for you and your family.

Still have questions? Contact Julie Hasselbach to discuss more.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
how can we help you?

Contact us at the Sprouse office nearest to you or submit a contact form.

Have questions about your insurance coverage?

Contact Sprouse Insurance to review your policies