Is Medicare Optional, or Can You Refuse Medicare?
Are you eligible for Medicare? What if you don’t need it – or don’t want it?
Do you have to get Medicare as soon as you’re eligible?
If you’re still working when you turn 65, or you become eligible through disability, you may be covered under your employer’s group plan. Or maybe your spouse has an employment-based or union-based group health plan that covers you. You usually don’t have to enroll in Medicare right away if you have a group health plan.
Traditional Medicare refers to Medicare Part A, which is hospital insurance, and Part B, which is medical insurance. Part A can be premium-free if you’ve worked and paid taxes long enough. (You need to have paid Medicare taxes for at least 10 years to get Part A without a premium.) If you qualify for premium-free Medicare Part A, there’s little reason not to take it.
In fact, if you don’t pay a premium for Part A, you cannot refuse or “opt out” of this coverage unless you also give up your Social Security or Railroad Retirement Board benefits. You’d also have to pay back your previous benefits to the government.
Why wouldn’t you want Medicare?
Part B comes with a premium in most cases. Some people delay enrollment in Medicare Part B to avoid paying the premium – especially if they have other coverage. The same can be true of Part A, for people that must pay a premium for it.
If you delay enrollment in Part B or Part A, make sure you plan it well to avoid problems. For example:
- Group health plans may have different coverage rules if you’re eligible for Medicare coverage. Check with your plan and ask how it would work with and without Medicare.
- You might face a late enrollment penalty if you delay Part B and/or Part A coverage. To avoid a penalty, make sure you enroll in Medicare promptly when your employment (or your spouse’s employment) ends, or when the group health coverage ends. After the month coverage or employment ends (whichever happens first), you might have an 8-month Special Enrollment Period (SEP) to enroll in Medicare without a penalty. Ask your benefits administrator, or contact Medicare.
Call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. Medicare representatives are available 24 hours a day, seven days a week.
Will I get enrolled in Medicare if I don’t want it?
If you don’t want Medicare, you still might get enrolled anyway. If you’re already getting Social Security benefits when you become eligible for Medicare, you’re enrolled automatically in most cases.
So, if you don’t want to be enrolled, you may be able to opt out. Follow the instructions in your Welcome to Medicare packet, which Medicare sends you during the three months before you’re eligible, in most cases.
We’re always happy to answer your questions. Call one of our eHealth licensed insurance agents at 1-888-296-0117 (TTY users 711). Representatives are available from 8 AM to 8 PM Monday through Friday, and from 10 AM to 7 PM Saturdays, Eastern time.