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  Frequently Asked Questions

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Medigap

Should I sign up for Medicare Part A & Part B if I or my spouse are still working and are covered by employer or union health insurance?

You may want to wait to sign up for Medicare Part B if you or your spouse are working and have health coverage through you or your spouse's employer or union. (See FAQ: I work for a small employer,if you work for a small company)  If you enroll now, you would have to pay the monthly Medicare Part B premium, and the Medicare Part B benefits may be of limited value to you as long as the group health plan is the primary payer of your medical bills.

Note: If you are 65 or over and working for a small company (less than 20 employees) you should talk to your employee health benefits administrator before making any decision not to take Medicare Part B.  If your employer has less than 20 employees, Medicare is the primary payer and your group health insurance would be the secondary payer.  If you are under 65 and disabled, a company of less than 100 employees would be secondary to Medicare.

You may also wish to read our publication: Medicare and other Health Benefits: Your Guide to Who Pays First.

If you don't take Medicare Part B when you are first eligible because you or your spouse are working and have group health plan coverage through your or your spouse's employer or union that is primary, you will have a Special Enrollment period to sign up later for medicare Part B.

If you are disabled and working (or you have group health coverage from a working family member), the Special Enrollment Period rules also apply.

Special Election Period Rules or when you can sign up:
     Anytime you are still covered by the employer or union
     group health plan through your or your spouse's (or if you
     are disabled, a family member's) current or active
     employment, or

     During 8 months following the month the employer or union
     group health plan coverage ends, or when the employment
     ends (whichever is first).

Most people who sign up for Medicare Part B during a Special Enrollment Period do not pay higher premiums.  The Social Security Administration handles Medicare enrollments.  If you have more questions about enrolling in Medicare Part B, you should call the Social Security Administration at 1-800-772-1213.  You can visit their Web Site.

 

 

 


 

 

 

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Board on Aging & Long Term Care
1402 Pankratz Street, Suite 111
Madison, Wisconsin  53704-4001
FAX:  608 246 7001
BOALTC@Wisconsin.Gov