When does my husband sign up for Medicare?

1 answer | Last updated: Sep 14, 2016
Dcave asked...

My husband is 66 and currently employed full time. He is insured with my employer's group insurance. He will begin receiving Social Security in November. Do we sign up for Medicare at this point or wait until he is ready to retire?

Expert Answers

The short answer is that he should sign up for Medicare Part A hospital insurance right away (it's free) but as long as he's insured under the insurance you have from your current employment, he does not need to enroll in Medicare Part B medical insurance (which charges a monthly premium) unless it would be cheaper for him than staying on your insurance

To understand how this works, you need to know that Medicare operates together with employer-sponsored health insurance in two different ways, depending on whether the insurance is provided through current employment or through a retirement plan. As long as health insurance is provided through current employment (yours or his), that group insurance is the primary payer, meaning it pays first (before Medicare) and to the full extent of its coverage. If the same person is also covered by Medicare, Medicare is the secondary payer, which means it only pays a portion of medical costs that the group insurance does not pay. In your situation, it is still worth it for your husband to enroll in Medicare Part A hospital insurance, even though this would be only secondary coverage, because Medicare Part A is free (no monthly premium). Medicare Part B medical insurance, which pays for doctor visits and most other outpatient charges, has a monthly premium of over $100, so it is usually not worth it to pay that premium just to get secondary coverage.

However, if you have to pay a high monthly premium to keep your husband on your group insurance, you might want to investigate the cost of Medigap (Medicare supplement) private insurance policies or Medicare Advantage (Medicare Part C) managed care plans, plus a Medicare Part D drug plan, for your husband. If your monthly premium for your husband under the group coverage is expensive, paying for Medicare Part B plus a Medigap insurance policy or a Medicare Advantage plan, plus Part D, might be cheaper than continuing his coverage under your group plan. Before making any switch, however, make sure that any new coverage would be accepted by the doctors he usually uses.

Once you retire and your employer-based group coverage -- if any -- for you and your husband comes through a retirement plan, the order of payment switches between Medicare and the group plan. Under most retirement health plans, Medicare becomes the primary payer, and in that case both you and your husband will need to enroll in both Medicare Part A and Medicare Part B, as well as in a Medicare Part D drug plan, or in a Medicare Advantage plan. Your retirement group plan would then help pay for costs that Medicare does not pay, acting as a sort of Medicare supplement plan.