Employer insurance with Medicare

Should I enroll in Medicare if I have employer insurance?

Before you make the ultimate decision, you should understand how your employer’s insurance can work with Medicare. Depending on the number of employees at your workplace, your employer insurance will either be the primary or secondary source of coverage. By having reputable coverage with your employer at the time of your eligibility, you may be able to avoid the late enrollment penalty when you do sign up for Medicare, but this is not always the case.

Turning 65 

If you are not receiving Social Security benefits at least four months before you turn 65, you will need to sign up with Social Security to get Original Medicare. Depending on your employer’s size, you can wait to get Original Medicare without having to pay the penalty if you enroll later. This is called a group health coverage plan. Enquire with your employer to determine if this is the case for them to avoid paying the penalty for enrolling in Medicare late. 

Over 65

If you are over the age of 65 with employer insurance or a group health coverage plan, you can enroll in Medicare without paying a late enrollment penalty. If you choose to enroll and your employer has 20 or more employees, then your employer insurance will be the primary source of coverage, and Medicare will be secondary. 

Under 65 with a disability

If you are under 65 but have a disability, you will automatically be enrolled in Medicare if you received disability benefits from Social Security or the Railroad Retirement Board for no less than 24 months. If you are working and covered by employer insurance, your employer insurance will be your primary source of coverage if there are more than 100 employees. 

After Employer Coverage Ends

After your employer coverage ends, you may be able to get coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), which will allow you to continue your health insurance through your employer’s plan for a period of time at a higher cost to you. Whether or not you choose to get COBRA coverage, you will have an eight-month grace period to sign up for Part B without a penalty. If you are already receiving COBRA coverage when you apply for Medicare, your COBRA coverage will end. COBRA coverage is always second to Medicare coverage. 

To know if your employer insurance provides primary or secondary coverage, contact your Human Resources department. For more questions regarding your eligibility for Medicare, give Temmen Insurance a call at 417-633-7200. 

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