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Should I Take Medicare Part B?

You should take Medicare Part A when you are eligible. However, some people may not want to apply for Medicare Part B (Medical Insurance) when they become eligible.

You can delay enrollment in Medicare Part B without penalty if you fit one of the following categories.

If you turn 65, continue to work, and are covered by an employer group health plan, you may want to delay enrolling in Medicare Part B. NOTE: Group health plans of employers with 20 or more employees must offer active workers who are 65 or older the same health benefits provided to younger employees.
If you turn 65 and are covered under your working spouse's employer group health plan, you may want to delay enrolling in Medicare Part B. NOTE: Group health plans of employers with 20 or more employees must offer spouses of active workers the same health benefits regardless of age or health status.
If you are under 65 and receive Medicare due to a disability, you continue to work, and are covered by an employer group health plan, you may want to delay enrolling in Medicare Part B. NOTE: Group health plans of employers with 100 or more employees must offer disabled workers, who are actively working, the same health benefits provided to other employees.
If you are under 65 and receive Medicare due to a disability, and are covered under your working spouse's employer group health plan, you may want to delay enrolling in Medicare Part B. NOTE: Group health plans of employers with 100 or more employees must offer the disabled spouses of active workers, the same health benefits given to non-disabled spouses.

Employer group health plans may cover items normally not covered by Medicare Part B. If so, and you meet one of the categories above or below, then you may not need to enroll in Medicare Part B and pay the monthly premium.

If you are:

an active worker
spouse of an active worker
disabled, active worker
disabled spouse of an active worker

and choose coverage under the employer group health plan, you can refuse Medicare Part B during the automatic or initial enrollment period. You wait to sign up for Medicare Part B during the special enrollment period, an eight month period that begins the month the group health coverage ends or the month employment ends, whichever comes first. You will not be enrolling late, so you will not have any penalty.

If you choose coverage under the employer group health plan and are still working (see categories above), Medicare will be the "secondary payer," which means the employer plan pays first. If the employer group health plan does not pay all the patient's expenses, Medicare may pay the entire balance, may pay only a portion, or may pay nothing.

An employer group health plan must be primary or nothing. They are NOT allowed to offer Medicare supplemental coverge to people who are actively employed -- unless the company has under 20 employees, or if disabled, under 100 employees.