Why Am I Being Forced into Medicare at Age 65?

Every American Aged 65 or Older is Eligible for Medicare

Senior man being examined by his doctor
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Nearly every American that is aged 65 years or older is eligible for Medicare, and almost all of them are eligible for Medicare Part A (hospital insurance) with no premiums.

However, not everyone 65 years or older wants to receive Medicare. Some individuals feel like that are being forced into Medicare at the age of 65 against their own personal wishes. Why is this the case?

Why Am I Being Forced into Medicare at Age 65?

If you or your spouse worked for at least 10 years in a job where Medicare taxes were withheld (including self-employment where you paid your own self-employment taxes), you'll become automatically eligible for Medicare once you turn 65.

Recent immigrants are not eligible for Medicare, but once they've been legal permanent residents for five years and are at least 65, they have the option to purchase Medicare coverage—as opposed to getting Medicare Part A for free—which is the same option available to long-term US residents who, for one reasons or another, don't have a work history that gives them access to premium-free Medicare Part A.

Those who receive Social Security benefits are automatically enrolled in Medicare when they turn 65. There is no way to opt out of Medicare once you are 65 if you receive Social Security. Either you enroll in Medicare Part A, or you forfeit your Social Security benefits. Most individuals are unwilling to forfeit their Social Security benefits, and thus accept the enrollment into Medicare. Note that you're only required to accept Medicare Part A—which is premium-free if you're receiving Social Security benefits—in order to retain your Social Security benefits.

You are allowed to reject Medicare Part B—which has a premium—if you choose to do so.

There is a great deal of speculation as to why the system is set up in this manner, but unfortunately, there is no clear or direct answer. Perhaps this policy was initially instituted to make it easier for seniors to enroll in Medicare once they reached they age of 65, but was never discontinued when private coverage became more commonplace.

Private coverage did not used to be as common as it currently is, which would leave many elderly individuals without health care. This presented an issue when they inevitably need health care.

Regardless of why the system is set up in the manner that it is, the rules are the rules, and they are not very likely to change in the near future. Thus, it is important to understand Medicare.

Termination of Company-Based Coverage at 65

If you're not yet 65 but are retired and receiving retiree health benefits from your former employer, make sure you're aware of the employer's rules regarding Medicare. Some employers don't continue to offer retiree health coverage for former employees once they turn 65, opting instead for retirees to transition to being covered solely by Medicare. Without coverage from your company, you need Medicare to ensure that you are covered for potential issues that come with old age.

Some companies will not cut an individual off completely at the age of 65, but instead continue to offer supplemental retiree benefits, which can be used in conjunction with Medicare (they may require you to enroll in both Medicare Part A and Part B in order to receive full benefits—as secondary coverage—from the retiree health plan).

The supplemental retiree health benefits may include prescription drug coverage (which isn't covered by regular Medicare, but can be purchased via Medicare Part D if you don't have access to supplemental employer-sponsored coverage), doctor visits, and other outpatient health care. Medicare will be your primary coverage if you're covered under a retiree health plan, with the plan offered by your former employer serving as secondary coverage.

Updated by Louise Norris.


Medicare.gov. Retiree Insurance.

Medicare.gov. Sign Up / Change Plans.

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