Ask the Expert: How Medicare works with employer plans
My wife will retire when she turns 65 in December. Our health insurance is through her job. I'm 67, but plan to work for five more years. When she retires, can she get Medicare while I get insurance through my employer? Must we both be covered through my employer? Should we both apply for Medicare?
You need to discuss this with a knowledgeable person at the insurer that covers your workplace plan, and double-check what you’re told with Medicare.
Your coverage through your wife's job ends when she retires. Her workplace plan probably insures 20 or more workers. (Otherwise, it wouldn't cover her 67 year-old spouse.) In that case, her deadline for penalty-free enrollment in Medicare is eight months after leaving her job or her workplace coverage, whichever comes first — unless your workplace plan will cover her.
If your employer’s plan covers 20 or more workers, it should provide primary health insurance for you and your spouse as long as you work there, even if you're both over 65. In that case, it could replace your wife's current plan, postponing her Medicare application deadline until you retire.
But if your workplace plan insures fewer than 20 people, when they turn 65 it becomes their secondary insurer and stops paying for anything Medicare covers. In that case, you must both apply for Medicare when your wife retires.
Either way, you should both go ahead and sign up for Medicare Part A (hospital coverage). It’s free for most people and it’s secondary coverage if you have primary coverage in a workplace plan. Indeed, some workplace plans require their Medicare-eligible participants to enroll in Part A.
The bottom line
As you approach your 65th birthday, it’s crucial to double-check your future health insurance options with your current insurer and with Medicare.
