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Ask the Expert: Medicare and employer-sponsored insurance

You've written that the deadline for enrolling in Medicare depends partly on whether someone has health insurance through a job at a company with 20 or more workers when he turns 65. My husband recently was in that scenario. When we called Medicare, one question they asked was "Does your company employ 100 or more people?" Does that question apply to a different scenario or is "20 employees" an error?

The question about 100 employees applies to a different scenario.

If you have health insurance through your own or your spouse's current job when you become Medicare-eligible at 65, it's vital to find out which insurance is primary. Primary insurance is the policy that kicks in first. Secondary insurance pays for some or all of what primary insurance doesn't cover.

In general:

• If you're covered through current employment at a company with fewer than 20 workers, when you turn 65, Medicare automatically becomes your primary insurance and your employer plan becomes secondary. If you haven't enrolled in Medicare, you'll have no primary coverage. The enrollment deadline is three months after your birthday.

• If you're covered through current employment at a company with 20 or more workers, that plan remains your primary coverage. Your deadline for penalty-free Medicare enrollment is eight months after the job or current coverage ends, whichever comes first.

• If you're covered through a previous employer, Medicare automatically becomes primary at 65.

• If you become Medicare-eligible while under age 65 because of a disability and you're covered through your own or a family member's current employment at a company with 100 or more employees, the employer coverage is primary. If the employer has fewer than 100 workers, Medicare is primary.

The bottom line

It's essential to learn which Medicare rules apply to you.

More information

medicare.gov/node/32951

medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/i-have-employer-coverage

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