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Medicare Enrollment if You Have Coverage Through Spouse

If you are about to turn 65 in Illinois or already eligible for Medicare, but currently receiving health coverage through your spouse, you may be wondering if you need to enroll in Medicare.

Medicare or Group

The size of your employer decides whether or not you can delay enrollment in Part B without a penalty. In companies with fewer than 20 employees, Medicare becomes the primary insurer, with group secondary. If your current insurance will become secondary, then you should take Part A and Part B when you are first eligible. The reason is that the secondary only pays after the primary pays. If you choose to delay Medicare, you will not have a primary, and your out-of-pocket costs will be costly. If your employer has more than 20 employees and your group will remain the primary with Medicare second, then you may not need to enroll in Part B immediately as your current coverage will cover you.

Current Coverage

Group coverage in Illinois works differently once you become eligible for Medicare. After determining which one pays first, look at your coverage and find out how your current coverage changes once you or your spouse turn 65. Then you can decide if it’s worth having both coverages or delaying enrollment in Part B.

Special Enrollment

If you have group coverage and missed your Initial Enrollment, you can still enroll in Part B without paying a penalty. As long as you have coverage, you qualify for a Special Enrollment. And, you have an additional 8 months after losing coverage to enroll without paying a penalty. You’ll also get a guaranteed right to buy Medicare Supplement Insurance for six months after enrolling in Medicare Part B.







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