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Our country has a patchwork of different types of health insurance coverage, including individual insurance policies, employer-based insurance coverage plans available through the new Affordable Care Act, Medicaid, and Medicare – the country’s flagship insurance program. While some people go without health insurance altogether, others have different types of coverage over the course of their lives, some people may even have more than one type at a time.  

The Medicare program has complicated rules about how other health insurance interacts with, or "coordinates" with Medicare coverage. This includes health insurance that someone has as a result of current, active employment. In certain circumstances, individuals can stay on their employer-based health coverage and forgo enrolling in Medicare Part B without penalty, until they retire. Unfortunately, people are often unaware of these complicated rules or get bad information about how they work. As a result, they may have to pay premium penalties and may face many months, or longer, without access to Part B coverage.   

To add to this complexity, when someone chooses to collect Social Security retirement benefits can affect the timing of, and information they receive about, enrollment in Medicare. Eligibility for Medicare is based, in part, on an individual’s work history (or that of a spouse) as recorded by the Social Security Administration (SSA). While most Americans are eligible for Medicare at age 65, full retirement under Social Security is increasing overtime to age 67. Further, while individuals can choose to take early Social Security retirement, at age 62, Medicare will still not begin until age 65. In addition, many people choose not to collect Social Security until they full Social Security retirement age, or beyond.  

All this can create significant confusion about enrolling in Medicare. An error in timing can mean individuals will be subject to premium penalties, limited enrollment opportunities, and/or delays in coverage if they do not enroll in Parts A and B when they are first eligible. Yet, little or no notice about Medicare enrollment is provided to the ever-increasing number of individuals who don’t collect Social Security retirement when they turn 65.

For more information on Medicare enrollment, see https://www.medicareadvocacy.org/eligibility-enrollment/.

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