Is It Mandatory to Go on Medicare When You Turn 65?

Medicare is not mandatory, though there is very little reason to turn down Medicare coverage if you qualify for premium-free Part A. Most beneficiaries qualify for premium-free Medicare Part A.

There aren’t many circumstances in which it may be beneficial for you to delay Medicare enrollment. You should consider this decision carefully. If you don’t sign up when you’re first eligible for Medicare but then decide to enroll later on, you could potentially face late enrollment penalties, such as the Part A and Part B late enrollment fees.

Why Should I Apply for Medicare?

There are several reasons many people may decide go ahead and enroll in Medicare, including: 

• If you qualify for premium-free Medicare Part A but choose to opt out of your coverage, you must also forfeit your Social Security or Railroad Retirement Board benefits. You would also have to pay back any previously received benefits to the government. 
  
  Most Medicare beneficiaries don’t pay a premium Part A because they or their spouse worked and paid Medicare taxes for at least 10 years, which qualifies them for premium-free Part A coverage even if they’re currently covered by health insurance offered by their employer.
  
  
• Medicare works with other types of insurance and can supplement your existing coverage. Being enrolled in Medicare will not prevent you from maintaining other forms of coverage, such as employer-provided health insurance or health insurance benefits provided through the Veteran’s Administration.

For example, let’s say you are not retiring at age 65 and will continue enrollment in your company’s health insurance plan. If your employer has 20 or more employees, the group health plan is the primary payer for your covered health expenses, and Medicare is the secondary payer. This means your employer-provided insurance plan will be the first to contribute to your health care expenses, and then Medicare will swoop in and contribute its share to your remaining covered costs. 

If your employer has fewer than 20 employees, Medicare is the primary payer, and your employer health insurance plan is the secondary payer. In this case, Medicare is the first to receive your health care bills and will contribute its share of cost coverage before passing on the remaining covered costs to your employer’s plan to contribute its share. This is also the case for those who are on Medicaid and those who are retired but still maintain a group health plan from their previous employer during retirement. 

If you aren’t paying a monthly premium for Medicare Part A (and most people don’t), there aren’t many reasons to not accept Medicare coverage.

This information can be confusing. To help you navigate your enrollment choices, you may want to consult this Medicare Part A and Part B enrollment information sheet from the Centers for Medicare & Medicaid Services (CMS).