- Coverage from different health insurance plans, such as a group insurance plan, and Medicare requires coordination of benefits, or which insurance will pay first. If you are still working and covered under a group plan, the group plan is the primary payer of your health care costs. It is not necessary to enroll in Part B Medicare. If the group coverage is for you in retirement, Medicare becomes the primary payer, and you should enroll in Part B.
- The employer group insurance rules apply if either you or your spouse is still working over age 65 and covered by the employer's insurance plan. Medicare rules allow someone in this situation to delay enrollment in Part B without penalty. Union-provided health insurance is also primary for someone still working over the age of 65. Medicare recommends that a working person enroll in Part A at age 65. The monthly cost of Part B can be put off until after retirement.
- If the employer providing the group coverage has less than 20 employees, an employee over age 65 should enroll in Part B. Small business insurance plans are allowed to make Medicare the primary payer for employees over age 65. Medicare recommends that employees of a small company approaching age 65 discuss the company's insurance coverage with the benefits administrator. If an employee of a small business does not enroll in Part B, some types of health care may not be covered.
- For those over age 65 who are still working and covered by a group health insurance plan, Medicare offers a special enrollment period. This enrollment period is in effect for as long as the individual over age 65 keeps working and for eight months after he stops working or the group health insurance coverage stops. An individual who enrolls in Part B can specify the effective date up to three months in the future. Enrollees, during the eight months after group coverage ends, will have Part B effective the first of the next month.
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