Can you force employees to enroll in Medicare?

Q         Can we make it mandatory for employees to enroll in Medicare upon turning age 65 even if they don't plan on retiring and continue using the group medical plan? If so, how must this be communicated to employees approaching Medicare eligibility?

A   It depends on the size of your company. The Age Discrimination in Employment Act (ADEA) prohibits employers with 20 or more employees from cancelling group health coverage for current employees due to age, even when they become eligible for Medicare. Additionally, employers with 20 or more employees cannot force employees to enroll in Medicare or offer any incentives to do so—it must offer the same coverage to those 65 years or older as it does to younger employees. In this case, the employee may choose to keep the employer’s health coverage, enroll in Medicare, or do both.

If you employ fewer than 20 employees, you can require employees to get Medicare when they turn 65. By doing so, Medicare becomes the employee’s primary health insurer, but she would have the option to cancel her employer’s health coverage or retain it as a secondary payer of covered insurance claims.

Communications regarding Medicare should begin as soon as practicable, and you should be able to explain the Medicare Parts (Parts A, B, D, and Medigap), the out-of-pocket costs typically associated with Medicare coverage, and the advantages of Medicare coverage.