When it makes sense to decline Part A of Medicare

There is no requirement that someone take Part A unless they are receiving Social Security, in which case they must take Part A.

A person with a health savings account who has filed for Part A may no longer make pre-tax contributions to their HSA; neither may their employer or anyone else. In this situation, it can make sense to reject Part A until a person no longer is eligible for an HSA.

If a person has not claimed Social Security, they do not have to take Part B. Unless they are covered by an employer group health plan, they usually won’t have health insurance. There is an exception when a person has not worked enough to qualify for Social Security. Failure to qualify means the person is not entitled to premium-free Part A of Medicare. Such a person is permitted to sign up for an Affordable Care Act health insurance plan at age 65 and later and need not get Medicare.

If a person gets a Medicare card from Social Security when they turn 65, they can reject coverage and send it back. It’s a good idea to call Social Security to make sure the agency does not mistakenly keep them enrolled.