Coverage While You and/or Your Spouse Works

If you and/or your spouse still works when you become eligible for Medicare, you will need to decide whether to sign up for Medicare or postpone your enrollment. Your employer or union representative may help guide you through this decision-making process.

When you or your spouse is actively working and covered by both Medicare and a Group Health Plan (GHP), certain federal rules apply that determine which health benefits pay first (the primary payer) and which pay second (the secondary payer), depending on the number of employees covered. These rules change when you or your spouse is no longer working, but is still covered by an employer or union GHP, or by a retiree package that is part of a GHP. For more information, see Retiree Plans.

Note: These federal rules may also apply when working parents have a child with a disability who is eligible for Medicare and covered by a parent’s employer GHP.

Note: If you have Medicare because of end-stage renal disease (ESRD), many of the rules described in this section do not apply to you. See our fact sheet Medicare and People with ESRD for more information.

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