Less than 20 employees?

If you work for a small company (under 20 employees), you MUST enroll in Medicare at 65.

You need to sign up before turning 65

If you work for a small employer (less than 20 employees) then you will need to sign up for both Parts A & B before you turn 65. This is because Medicare becomes the primary payer of your health costs and your health insurance is no longer responsible for the portion of the bill that would be covered by Medicare.

Different Rules for Small Companies

The laws that prohibit large insurers from requiring (or even persuading) Medicare-eligible employees to drop the employer plan and sign up for Medicare do not apply to companies and organizations that employ fewer than 20 people.

Medicare Pays First

When you turn 65 Medicare automatically becomes primary and the employer plan provides secondary coverage. In other words, Medicare settles your medical bills first, and the employer plan only covers services that it covers but Medicare doesn’t. Therefore, if you fail to sign up for Medicare when required, you will essentially be left with no coverage.

It’s therefore extremely important to sign up for Medicare before you turn 65 because if you do not sign up during your initial enrollment period you will have to wait until January to enroll and your Medicare benefit will not begin until July 1st, leaving you at risk.

Occasionally some insurance companies may offer to cover claims even if you don’t have Part B. Don’t risk it. The insurance company could change that decision at any time without warning, and leaving you stuck with all the expenses that Part B would normally cover. It’s not worth the risk.

“I always advise my clients to enroll in Parts A & B if the employer has fewer than 20 employees. It’s better to be safe then sorry.”

Todd Reagin, Insurance Broker

One Exception

The ONLY exception to this rule is for employers who participate in a “multi employer plan.”  In this case if one of the employers has more than 20 employees then all the employers in the group are entitled to an exemption and employees can postpone their Part B coverage. You can read more about that exception here: https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/EmployerServices/Small-Employer-Exception

Would you like my help?

If you would like to talk to me or schedule a meeting at your home or my office, you can reach me at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.

The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available.  I am paid by the insurance companies in the form of a commission if you enroll in a plan.

You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.  My goal is to help you and I have found great joy in being able to offer my services to people who need my help.

If you are turning 65 this year or retiring, you may have questions.

Call me today and I will be happy to explain all your options and help you compare plans so you can choose the coverage you need for a price you can afford.