Do I have to participate in Medicare?

1 answer | Last updated: Oct 20, 2016
Gbrown asked...

I am approaching 65 and would like NOT to participate in Medicare. Will my insurance co. (Anthem BC of CA) or the government force me to? I would like to continue with my current insurance. Thank you.

Expert Answers

There are two parts to your question. The first part is whether the federal government, which runs the Medicare program, requires you to participate. The answer to that is no. You are not required by the government to enroll in any part of Medicare at any time. Enrolling in Medicare Part A, however, does not cost you anything, so there is no reason not to do so. You should also be aware that if you don't enroll in Medicare Part B when you first become eligible for it at age 65, and then later decide that you do want to enroll, you will be permitted to enroll only between January 1 and March 31 of any year, and you may pay a penalty in the form of permanently higher premiums of 10 percent per year for every year you delayed. (There is no penalty if you were enrolled in employer-sponsored insurance, based on your current employment, during the delay.)

The second part of your question is whether your current insurance company will require you to enroll in Medicare. That depends entirely on the terms of your specific insurance policy. If you are enrolled in your insurance through your current work, that private insurance probably will provide your primary coverage whether or not you enroll in Medicare. If you enroll in Medicare, Medicare might pick up most of the portions of your medical costs that your private insurance does not cover. But under employer-sponsored insurance, the insurance company may not care whether you or Medicare pays bills that it doesn't pay.

If you are enrolled in employer-sponsored insurance as a retiree, however, rather than from current employment, things usually work differently. In that situation, the private insurance might pay only the portions of your medical costs that Medicare does not pay. So, under the rules of that type of policy, you might need to enroll in Medicare in order to get most of your medical expenses paid. The same thing may be true if you have an individual private insurance policy that is not employer-sponsored.

In any of these situations, you need to read your policy carefully to find out its requirements, if any, regarding Medicare enrollment. If your insurance is through your current or former employer, the benefits or human resources office there may be able to direct you to the provisions of the policy that determine your obligations, if any, with regard to Medicare.