How Does Employer’s Insurance Work with Medicare?

Eligibility for Medicare starts at the age of 65. Some people who are still actively working even after turning 65 may also have an employer’s medical insurance. Due to this, you can have both Medicare and employer’s insurance after age 65 to ensure that your healthcare needs are covered.

It is always a good idea to talk to your HR department, benefits manager, or an experienced insurance company like Temmen Insurance, but read on to learn more about how employer coverage can work with Medicare.

Employer’s Health Insurance and Medicare Correlation

One type of insurance coverage is not supposed to replace the other; they can work in conjunction, and they have the coordination of benefits. Employer’s insurance can work together with your Medicare benefits to cover your medical needs and help pay for most medical expenses. The size of the company determines which way the employer’s health care coverage will coordinate with your Medicare coverage. It will also determine if your Medicare or employer health plan is a primary or secondary payer to your medical costs.

The primary payer means that Medicare covers the first insurance claims. On the other hand, secondary means Medicare pays for the insurance claims only after the company you are working for covers the initial claim. If your company has less than 20 employees, then Medicare will serve as the primary coverage, but it will be the secondary coverage if your company has more than 20 employees.

Delayed Enrollment into Original Medicare and Part D

What happens if you delay enrollment into Original Medicare and Part D (prescription drug coverage) because you are still an active employee? Medicare beneficiaries that still have active employer coverage must pay for Part B benefits. You will have to pay a monthly premium on your Part B, and the amount you pay is also based on your salary.

Once you turn 65, you can decide to delay enrolling in Medicare Part B and not have to pay the late enrollment penalty. If you were to retire or leave your job, your employer would provide proof of resignation, showing that you are no longer receiving the employer’s insurance health coverage. Moreover, you can also delay enrolling in Medicare Part D coverage. If the employer plan covers prescription drugs, it is possible to avoid paying the penalty for enrolling late for Medicare Part D.

Can I choose my Primary Insurance?

There is also another option. If you are with a large company`s group health plan you can decide to leave that insurance and select Medicare as your main insurance. Using Medicare as your primary insurance can be cheaper for you, and it will also eliminate doctor copayments and reduce your deductible.

If you need more help understanding employer insurance and Medicare coverage, Temmen Insurance can help. Our insurance experts can walk you through all of this and offer the best recommendation based on your medical needs and budget to choose the best medical coverage and insurance plan for you.

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