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Is Medicare Mandatory at 65?

"Is Medicare Mandatory at 65?" text over image of Medicare enrollment form

Are you wondering, “Is Medicare mandatory at 65?” Our licensed, experienced agents can help answer the important questions you have about Medicare. Give us a call today at (800) 950-0608.

Just the Essentials...

  • The technical answer is no, it is not mandatory to enroll in Medicare at 65

  • Depending on your circumstances, enrolling late may require you to pay certain late enrollment penalties

  • It’s always best to enroll in Medicare as soon as you become eligible

Medicare Enrollment Can Be Tricky, We Can Help

The Medicare system can be very complex, with a lot of twists and turns to navigate. Because it’s so complex, it’s normal to have a lot of questions about eligibility and enrollment. Two of the most common questions have to do with whether or not enrollment at 65 is a requirement.

  • “Is Medicare mandatory at 65?”
  • “Is Medicare required for me when I reach a specific age?”

In today’s article, we’re going to explore the question of whether or not you’re required to sign up for Medicare when you turn 65. Like the system itself, the answer has many different layers.

Technically, You Aren’t Required to Sign Up for Medicare at 65

At the age of 65, you become eligible to receive Medicare benefits. In some cases, you enroll automatically once you turn 65 if you’ve received Social Security or Railroad Retirement Board benefits for at least 4 months. If you aren’t eligible for automatic enrollment, and you’re new to the system, you may be wondering:

Medicare has three specific periods for enrollment:

So, let’s say you’re eligible for Medicare, but you’re not ready to sign up just yet. This still begs the question: is Medicare required?

Technically, you’re not required to enroll in Medicare at age 65. However, it must be said that if you choose to wait, you may face late enrollment penalties. There are certain circumstances in which you may not face penalties for late enrollment, but those are few and far between.

What Are Late Enrollment Penalties?

You’re generally expected to sign up for Medicare during your seven-month IEP. If you do not enroll during your IEP, you’ll have to wait until Medicare’s GEP or AEP to do so. You must know, though, that if you wait to sign up during a different enrollment period, you’ll likely be subject to a late enrollment penalty for Original Medicare (Medicare Part A and Part B) and/or Medicare Part D Prescription Drug Coverage plans.

For example, let’s say you’re eligible for Medicare, but you choose not to enroll in Part B during your IEP. When you do choose to enroll in Part B, you’ll be subject to pay a late enrollment penalty unless you’ve encountered certain life events or special circumstances. The life events or circumstances that allow you to enroll in Part B at any time without having to pay a late enrollment penalty include:

  • Being currently employed and enrolled in your job’s group health plan
  • You’re currently serving as a volunteer outside of the United States
  • You’re involved in certain situations with TRICARE

Any of these events may qualify you for a Special Enrollment Period (SEP) during which you can sign up for Medicare.

How much you’ll have to pay, and how often, is determined by plan type. Using Part B again as our example, the late enrollment penalty lasts for as long as you have Medicare. The amount you’ll pay for enrolling late in Part B is determined by how many months have passed between eligibility and purchase. To avoid having to pay late enrollment penalties, it’s always best to learn from Medicare when to enroll in a plan.

I’m Still Working and Have Employer Coverage - Do I Have to Enroll?

In a situation where you’re of age to enroll in Medicare and still working, it all depends on the size of your employer. In certain scenarios, while you’re technically not required to sign up for Medicare at 65, not doing so may leave you with higher-than-desired medical expenses.

If you work for a large employer, defined as an employer with 20 or more employees, you have more options. Larger employers typically offer group health insurance plans as part of their benefits package, and if you’re enrolled in your employer’s group health insurance plan, then you have little to no need to enroll in Medicare at this time. In essence, your employer’s group health insurance will cover most everything Medicare plans would cover and more. 

For those of you who work for smaller employers, defined as employers with less than 20 employees, signing up for Medicare would be more beneficial. While smaller employers may offer health care plans, they aren’t as comprehensive as plans offered by larger employers and pay secondary to what a Medicare plan would pay if you were enrolled in one. If you work for a smaller employer and are 65 or older, it would be to your benefit to enroll in a Medicare plan so that you can have adequate healthcare coverage.

After Signing Up, When Do I Start Medicare?

If you choose to enroll, you may have one remaining question on your mind: “When do I start Medicare?” When your coverage begins may differ depending on when you first enroll in a Medicare plan.

Your actual start date for coverage depends on when you enroll. For instance, if you sign up during your IEP, you can expect coverage to begin around the following times, depending on when you first sign up:

  • If you sign up anytime during the three months prior to your 65th birthday, your coverage will start the month you turn 65
  • If you sign up during the month of your 65th birthday, your coverage will start the month after
  • If you sign up the month after you turn 65, your coverage will start two months after you sign up
  • If you sign up two to three months after you turn 65, your coverage will start three months after you sign up

When you sign up during AEP, your coverage begins January 1. If you wait to sign up during GEP, your coverage will not begin until June of that year.

It’s important to remember that, no matter when you choose to sign up, actually signing up to receive the Medicare benefits that you’ve worked for is one of the best moves you can make. Signing up for Medicare at 65 may not be mandatory, but it’s crucial to receiving the healthcare benefits you need.

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