Are you forced to take Medicare at 65?

Asked by: Violette Kessler  |  Last update: May 11, 2025
Score: 5/5 (29 votes)

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.

Can you refuse Medicare when you turn 65?

Because if you're already receiving Social Security or railroad benefits, you'll be automatically enrolled in Medicare Parts A and B when you turn 65. You can choose to opt out of Part B, but you'll likely be penalized and have to pay a higher premium if you decide to enroll later.

Is there a penalty for refusing Medicare?

What are the Medicare Part B late enrollment penalties? Generally speaking, if you do not sign up for Medicare on time, you may have to pay a 10% surcharge on Medicare Part B premiums for each year you go without coverage starting the month you're eligible for coverage.

Why am I forced to go on Medicare?

Because the cost and frequency of medical care zooms up after age 65, the system requires you pay premiums and get a subsidy. When you are under 65 and on Medicaid, your choices are limited, you need cheaper care and you may get 100% free care. You must enroll in Medicare after age 65.

Can my employer force me to enroll in Medicare at age 65?

Medicare-eligible employees and spouses can continue with the employer plan and choose to ignore Medicare, if that is best. Or they can choose to drop the plan and enroll in Medicare. Small employers are not subject to MSP rules or age discrimination rules for employment.

Medicare: Why you need to sign up when you're 65, even if you're still working

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Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

Can seniors opt out of Medicare?

The rules for opting out are very specific. In order to opt out you must file an opt-out affidavit with the Medicare Administrative Contractor (MAC) or Carrier that administers any jurisdiction you practice in. A template for this affidavit that conforms to Medicare rules follows.

How much does Medicare cost per month?

Here's what you'll pay for Medicare Part B: Premium: $185 per month, although you could pay more depending on your income. Higher-income beneficiaries: An additional $74 to $443.90 per month on your premium if your income exceeds certain thresholds. This is the income-related monthly adjustment amount (IRMAA).

Is it illegal to not accept Medicare?

Doctors or other health care providers who don't want to work with the Medicare program may "opt out" of Medicare. Medicare won't pay for items or services you get from provider that opts out, except in emergencies. Providers opt out for a minimum of 2 years.

Why would someone over 65 not have Medicare?

Medicare Part A Based on Age for People Who Must Pay a Premium. People who must pay a premium for Part A do not automatically get Medicare when they turn 65.

Is it a good idea to get Medicare if you're still working at 65?

If your or your spouse's employer has 20 or more employees and a group health plan, you don't have to sign up for Medicare at 65. But if you get Medicare Part A for free, typically you should sign up. (After all, it's free.) In some cases, Medicare Part A may cover what your employer plan doesn't.

Why are doctors refusing Medicare?

In recent years, physician groups and some policymakers have raised concerns that physicians would opt out of Medicare due to reductions in Medicare payments for many Part B services, potentially leading to a shortage of physicians willing to treat people with Medicare.

Is Medicare mandatory for seniors?

You're not required to enroll in Medicare when you turn 65. However, if you don't enroll when you're first eligible you might be subject to Part A, Part B, and Part D late enrollment penalties.

Why is Medicare so expensive?

Medicare costs, including Part B premiums, deductibles and copays, are adjusted based on the Social Security Act. And in recent years Part B costs have risen. Why? According to CMS.gov, “The increase in the Part B premiums and deductible is largely due to rising spending on physician-administered drugs.

Can a patient choose not to use Medicare?

This means that it is not illegal to not use your health insurance for medical services. Medicare patients may have different requirements. Patients can elect to pay for medical services if they find it in their best interest to pay for them directly.

Can I avoid paying Medicare?

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.

How to decline Medicare at age 65?

2 ways to drop coverage
  1. Contact Social Security.
  2. If you recently got a welcome packet saying you automatically got Medicare Part A and Part B, follow the instructions in your welcome packet, and send your Medicare card back.

Why do people say not to get a Medicare Advantage plan?

Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.

Do I have to take Medicare if I collect Social Security?

You must keep Medicare Part A if you're receiving Social Security benefits, however, you can defer Medicare Part B if you have other creditable coverage that meets Medicare's standards, such as employer coverage.

Can I drop my employer health insurance and go on Medicare Part B?

Once you stop working (or lose your health insurance, if that happens first) you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare (or add Part B to existing Part A coverage).

What are the disadvantages of opting out of Medicare?

Note that if you opt out, not only will Medicare and Medicare Advantage plans not pay you, they also will not pay any entity to whom you might reassign your right to receive payment for services, unless the services are for emergency care or urgent care.