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Medicare and Employer Health Insurance
If you are age 65+ (or turning 65 soon) and still actively working, you have some decisions to make regarding your health insurance. Contrary to what some believe, you don’t have to give up your employer health coverage and go on a Medicare plan. You can actually continue on your employer’s plan and your employer is obligated to let you stay on it, but there are differences that can come up depending on the size of your employer.
We can help you navigate the complexities of the process and narrow down what you need. There’s no obligation to enroll.
How does Medicare work with employer health insurance?
If you’re actively working and want to keep your group health plan, you may be able to delay enrolling in Original Medicare Part A and Medicare Part B without having to pay a penalty when enrolling later. The size of the company you work for determines how your Medicare benefits will coordinate with your employer coverage.
Large Company with 20+ Employees
Your employer group coverage will be your primary insurance and your Medicare benefits are secondary, if you decide to sign up. Most active employees with group coverage enroll in Part A, as it is premium free if you’ve worked at least 10 years. If you want to delay both Part A and Part B coverage, you don’t need to do anything when you turn 65.
Smaller Companies with Less Than 20 employees
If you work for a company with fewer than 20 employees, Medicare will become your primary insurance. You can still continue to be covered by your employer insurance, but that will become your secondary. If you have small employer group coverage, it is recommended that you enroll in both Part A and Part B as soon as you’re first eligible for Medicare.
Regardless of company size, it’s important to talk with your benefits administrator to plan out what you should do with your medical coverage. We can help you navigate the complexities of your benefits, to make sure you’re getting the best coverage. There’s no obligation to enroll.
Additional Considerations and Medicare Information
- Timing is Important – If you’re eligible for premium-free Part A, you can enroll in Part A at any time after you’re first eligible for Medicare. Your Part A coverage will go back (retroactively) six months from when you sign up but no earlier than the first month you’re eligible. If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, you may have to pay a penalty.
- Double Down – Keeping your employer coverage and adding Medicare can be a plus when it comes to filling in coverage gaps. Just remember that once Medicare becomes your primary insurance, all claims go through Medicare first while any non-covered costs can be submitted to your employer plan.
If you have other insurance in addition to Medicare or make any changes to your insurance, you need to let Medicare know by calling Medicare’s Benefits Coordination & Recovery Center (BCRC) at 1-888-798-2627. TTY users call 1-955-797-2627.
- Automatic…or not? – If you already receive Social Security benefits or Railroad Retirement benefits you’ll be automatically enrolled in Medicare the first day of the month you turn 65. You’ll also be automatically enrolled if you’ve received disability benefits for 24 months or have started receiving due to an ALS diagnosis. If none of the prior apply, you’ll need to sign up online or in person.
- Make Comparisons – Take time to compare the cost of your employer coverage against what it would cost you to roll over to Medicare as your primary insurance. Doing research will help you decide which coverage is most cost-effective. It can also help you avoid any Medicare late enrollment penalties wherever possible.
- Don’t Hesitate to Ask – Making decisions about your health coverage—especially when you’re employed and turning 65—is best done with the help of an expert. It’s important to begin the discussion with the benefits administrator at your work, and even better if you have the chance to talk before your 65th birthday. You’ll also want to talk to the experts on the Medicare helpline at 1-800-633-4227 (TTY users call 1-877-486-2048) or by making an appointment at your local Medicare office.
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We can help you better understand your options and save you time and the hassle of navigating the Medicare maze on your own. In just minutes, we can compare all Medicare options available in your area from our trusted carriers and ensure you’re getting all the benefits you deserve. There’s no obligation to enroll.