Medicare pays first in all situations unless you (or your spouse) are currently employed and covered by an employer group health plan. In this situation, there will be no surcharge if Medicare is refused until employment ceases. If you are not working, whether your employer provides benefits or not, Medicare is primary and you should enroll. If you refuse Medicare at age 65 and again don't accept Medicare when you retire, you will risk a premium surcharge and possibly a delay in receiving Medicare benefits.
Medicare is the government’s medical insurance policy designed as a means of assisting retired American citizens with medical expenses. Medicare is part of the Social Security Act of 1965 and was signed into law by Lyndon B. Johnson. As a means to keep the system running, current working individuals pay into the system to cover the costs of those who are currently retired.
The general rule is that anyone who is a legal resident of the United States for 5 years and who has paid into the Social Security system for 10 years qualifies for Medicare. If neither the applying resident or their spouse have paid into the system for at least 10 years, then they must pay a premium to become a member. In addition, if you are under 65 and either have end stage renal disease, need a kidney transplant, or have Lou Gehrig’s disease you also qualify for Medicare insurance.
For someone already enrolled with a private insurance company, Medicare will cover any additional expenses that the insurance company did not pay when the expenses are medically necessary. Examples of expenses covered by Medicare include short nursing home stays, hospital stays, medically necessary surgeries and treatments, and prescription drugs. The key to keep in mind is that everything paid for must be deemed medically necessary.