Medicare and Employer Health Insurance

Mike Olmos by Mike Olmos | Licensed since 2010
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This article was updated on: 10/21/2018

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Do I need to enroll in Medicare when I turn 65 if I’m still working?

If you have health care coverage through your employer, you may choose to delay enrollment in Medicare Part B when you turn 65, since Part B includes a monthly premium. You may be able to sign up at a later time through a Special Enrollment Period, without facing a late-enrollment penalty. If you haven’t worked enough quarters to get Medicare Part A without paying a premium (40 quarters, which is 10 years), you can decide to delay Part A as well. If you worked at least 10 years and paid Medicare taxes, you generally will receive premium-free Part A coverage.

Can I combine employer health insurance with Medicare?

If you or your spouse are working and covered through an employer, you can also decide to keep this coverage and enroll in Original Medicare, Part A and/or Part B to get additional health coverage. If you’re receiving Social Security benefits, in most cases you will be automatically enrolled into Medicare Part A and Part B at age 65. If you decide to enroll in Medicare Part A and/or Part B while keeping your employer coverage, there is a process in place to determine which insurance will be considered the primary payer called “coordination of benefits.” If your employer coverage is determined to be your primary insurer, it pays your health-care costs first. Medicare then covers a certain amount of the remaining Medicare-approved expenses. When your employer plan is the secondary insurer, it only covers a specific amount of leftover expenses. In this scenario, Medicare is the primary insurer and pays its share first.

When you enroll in Medicare Part A and/or Part B, you should list out any other insurance you have in your Initial Enrollment Questionnaire. If you have questions about how Medicare and other insurance work together, contact your current benefits administrator for more information.

How can I get prescription drug coverage?

Keep in mind that Original Medicare, Part A and Part B, generally doesn’t include prescription drug coverage for prescription drugs you take at home. If your employer coverage doesn’t include drug benefits, you may want to enroll in a Medicare Prescription Drug Plan to get this coverage. If you don’t, you could face a late penalty for not signing up when you’re first eligible and going without creditable prescription drug coverage.

If you have any questions about your Medicare coverage options, I’m here to help. If you’d like, use the links below to set up a time to speak over the phone or by email. If you’d like to see what plans are available now, use the Find Plans button on this page to view plans.

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