Is Medicare mandatory?

Strictly speaking, Medicare is not mandatory. But very few people will have no Medicare coverage at all – ever. You may have good reasons to want to delay signing up, though.

One key reason to delay Medicare Part A (hospital insurance) is because you may want to keep contributing to a health savings account (HSA) which allows you to save money tax-free. Once you enroll in any part of Medicare – even if it’s only premium-free Part A – you can no longer put money into an HSA.

You can still use the funds to pay for qualified health care costs though. (Note: You can’t refuse or delay Part A if you receive Social Security benefits, unless you forfeit your benefits.)

Check with your plan benefits administrator about your options. If you do decide to delay, you’ll want to first make sure you’ll qualify for a Medicare Special Enrollment Period when your employer insurance ends. If you don’t, you may have to pay late enrollment penalties.

Another reason you might want to delay Part A is you can’t get it premium-free. People who have to pay a premium for Part A may consider delaying enrollment to avoid the expense. Part A charges a penalty for late enrollment, though. An alternative in this case is to get a Marketplace plan instead of Medicare.

You may want to delay Medicare Part B (medical insurance) to postpone paying the monthly premium that comes with it. Pay attention to timing when you’re ready to enroll, though. Part B charges a late enrollment penalty unless you qualify for a Special Enrollment Period. You may qualify if you have creditable coverage through an employer or union.

Speak with your plan benefits administrator before delaying Part B. They can help you find out if you would have creditable coverage and if you can delay or if you need to enroll in Medicare at 65.

There are few reasons you may consider delaying Medicare Part A or Part B for, so learn about your choices and make a plan for Medicare enrollment that works for you.