Do You Need Medicare If You Have Employer Health Insurance?

August 2, 2021
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If you are still working when you turn 65, you will be eligible for both Medicare and your employer’s health insurance. The question is, do you need Medicare?

Signing Up for Medicare While Working

You first become eligible for Medicare 3 months before your 65 birthday. During this time, the month of, and 3 months after, you can enroll in one or more of the Medicare plans of your choosing.

The most common of these is Original Medicare, which includes Part A and Part B. More often than not, you will be automatically enrolled. You should receive a letter in the mail informing you of your new enrollment.

But not everyone wants Medicare while they have employer health coverage. If you decide to delay enrollment, you can follow the instructions sent with your automatic enrollment notice, or contact the Social Security office.

Typically, if you were to choose to delay your Medicare enrollment, you would be penalized for each year you went without coverage. Those with employer coverage, however, are exempt for as long as they are working. When you retire and your employer insurance ends, you have 6 months to enroll in Medicare before the late penalty kicks in.

Why You May Want Both

However, not everyone chooses to wait. In fact, a majority of people don’t. Having two insurance plans means double the coverage, and the less that comes out of your pocket for healthcare expenses.

You will almost certainly want both if you work at a small company. Employers with less than 20 employees will definitely benefit from the substantial coverage Medicare has to offer. Or, you could choose to suspend your employer benefits altogether if you feel you are paying too much for the coverage you are given, and switch over to Medicare.

How the Two Work Together

With both insurance plans active at once, your coverage will work a bit differently than it would normally. If you have an employer with less than 20 members on its group health plan, Medicare will serve as your “primary insurer.” This means, whenever you receive a covered benefit, Medicare will contribute its share of the cost first. Then, if your employer plan also provides coverage for the same benefit, it will contribute its share.

On the other hand, if you have Medicare and a group health plan with more than 20 members, it will be the opposite–the group health plan will be your primary insurer, Medicare your secondary.

Why You May Want to Wait

If your group health plan has more than 20 members, however, you may just choose to delay your enrollment. If you feel that your benefits are substantial enough on their own, and you would rather wait to cover the additional Part B premium for a while, you may do so. 

Plan Your Medicare Coverage with Healthcare Solutions Direct

If you’re still working, knowing how and when to enroll in Medicare is difficult. If you want expert help and advice, or just want to prepare for the future, give Healthcare Solutions Direct a call now!

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