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Approaching 65 and still working? Many Canadians are finding themselves in this situation, and it presents a crucial decision regarding Medicare enrollment. While Medicare eligibility kicks in at 65, you might be able to delay signing up without facing penalties, especially if you have health insurance through your employer. This guide breaks down the rules and what you need to know to navigate this process successfully.

Understanding the Rules: Employer Coverage and Medicare Delay

The good news is that if you – or your spouse – are still employed and covered by a health plan from an employer with 20 or more employees, you generally can delay enrolling in Medicare. This is a significant benefit, allowing you to maintain your current coverage and avoid potential complications with Medicare.

However, it's vital to understand the specifics. The key factor is the size of the employer. A company must have 20 or more employees to qualify. If your employer has fewer than 20 employees, you'll likely need to enroll in Medicare at age 65, even if you're still working.

Why Delay Medicare?

There are several compelling reasons why delaying Medicare enrollment might be advantageous:

• Maintain Existing Coverage: You likely have a health plan you’re familiar with, a network of doctors you trust, and potentially lower premiums compared to Medicare.
• Avoid Potential Coordination of Benefits (COB) Issues: COB can get complicated when you have both employer coverage and Medicare. Delaying enrollment simplifies this.
• Time to Evaluate Medicare Options: Delaying allows you more time to research and compare different Medicare plans (supplemental, drug coverage, etc.) before making a decision.

Important Considerations & Potential Pitfalls

While delaying Medicare can be beneficial, here are some crucial points to keep in mind:

• Employer Coverage Must Be Creditable: Ensure your employer's health plan is considered “creditable coverage.” This means it's at least as good as Medicare coverage, and it prevents gaps in coverage that could impact your ability to enroll in Medicare later without penalties. Your employer should provide you with this information.
• Keep Records: Document your employer coverage. Keep records of your health insurance plan details and any communications related to creditable coverage.
• Know Your Enrollment Window: Even if you delay enrollment, you have a limited window to enroll in Medicare after your employer coverage ends. Missed deadlines can result in penalties.
• Spouse's Coverage: Remember, the rules apply if either you or your spouse has employer coverage with a qualifying employer.

What Happens When Employer Coverage Ends?

When you leave your job or your employer's health plan ends, you'll need to enroll in Medicare. You generally have eight months from the end of your coverage to enroll without penalty. It's best to enroll promptly to avoid any potential gaps in coverage.

Consult a Professional

Navigating Medicare can be complex. Consider consulting with a financial advisor or insurance broker specializing in Medicare to ensure you make the best decisions for your individual circumstances. They can provide personalized guidance and help you understand all your options.

Disclaimer: This information is for general guidance only and does not constitute legal or financial advice. Always consult with a qualified professional for advice tailored to your specific situation.