Medicare & Employer Coverage

If you are eligible for Medicare and you currently have a group health plan from your employer, you can still enroll in Medicare. However, you can either choose to enroll in Medicare as soon as you become eligible or delay your enrollment, depending on the size of the company.

Medicare and Employer Insurance

Medicare is a federal health plan that is available to individuals aged 65 or older or people who meet other criteria needed to qualify. Medicare provides individual coverage and covers approved inpatient and outpatient healthcare services.

Employer insurance is commonly known as a group health plan. It is a health insurance package that is offered by employers to active or full-time employees. Some group health plans extend health coverage to employees’ dependents or spouses. However, the coverage features depend on the type of insurance offered by the company.

Medicare and employer coverage can work together to cover the majority of your healthcare expenses. Depending on the size of your company, either of the two will serve as the primary or secondary insurance if you decide to keep the two plans. The primary insurance coverage will pay out first while the secondary coverage will cover the remaining approved costs.

If you work in a company with fewer than 20 employees and you have Medicare and employer insurance, Medicare will be the primary insurance. If there are 20 or more employees, Medicare will be the secondary insurance. If your employer insurance coverage extends to your dependents or spouses, Medicare will cover individual healthcare expenses while your group health plan will provide joint coverage.

Enrollment

If you work in a company with 20 or more employees, you can delay your Medicare enrollment until a later date without any penalty. After you retire or lose your employer group plan, you will have a Special Enrollment Period to enroll in Part A and Part B (Original Medicare).

However, if you work in a company with fewer than 20 employees, you will need to sign up for Medicare during your Initial Enrollment Period if you are not automatically enrolled. This enrollment period will start three months before your 65th birthday month and ends three months after your 65th birthday month.

Call us today at 405-694-0892 for more information about Medicare and how it can work with employer health coverage.

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