If you are turning 65 soon, or are 65+, and currently have group health insurance based on the active employment of either you (or your spouse), you have a couple of options to think through when it comes to your coverage. So let’s dig right in…
What Are My Options?
You can either join Medicare, or keep your current coverage. We recommend weighing your options to see which coverage will provide you with the best benefits for the lowest premiums.
From our experience, approximately 50% of the time it is best to stay on group coverage, and the other 50% of the time, it is better to join Medicare. This decision should be based on comparing what you currently pay for your health insurance versus what you would pay for Medicare. Additionally, comparing a few of the major benefits such as the deductible and copays.
If Your Employer has 1-19 Employees:
- Medicare is primary, your employer coverage is secondary
- You may be required to join Original Medicare (Parts A & B)
- It is up to your group insurance company (Such as: Aetna, Blue Cross, Etc.) to decide if they require you to join Medicare or not
- There is no late enrollment penalty as long as:
- Your coverage is credible
- Your coverage is based on the active employment of you or your spouse
If Your Employer has 20+ Employees:
- Your employer coverage will be primary, Medicare is secondary
- You are not required to join Medicare; as your employer and insurance company must treat all 65 and over employees the same as 65 and under employees
- There will be no late enrollment penalties as long as:
- Your coverage is credible
- Your coverage is based on the active employment of you or your spouse
Medicare and COBRA Coverage:
Be very careful if you have COBRA, as it is NOT credible healthcare coverage and the loss of COBRA coverage does NOT create a Special Enrollment Period for Part B.
If you are on COBRA and become eligible for Medicare:
- You should enroll in Part B immediately because you are not entitled to a Special Enrollment Period (SEP) when COBRA ends
- Your COBRA coverage will usually end on the date you enroll in Medicare
- Your spouse and dependents may keep COBRA for up to 36 months regardless of whether you enroll in Medicare during that time
- You may be able to keep COBRA coverage once you get Medicare for services that Medicare does not cover such as Dental & Vision (if your insurance company agrees).
If you have Medicare when you become eligible for COBRA:
- You must be allowed to enroll in COBRA, which will pay secondary to Medicare
- COBRA may be beneficial if you have generous benefits like low premiums and good RX coverage
Part D Coverage:
- COBRA RX coverage may be credible. If it is, there is no penalty for delaying your enrollment into a Part D RX plan
- You MUST enroll in a Part D plan within 63 days of loosing credible Part D COBRA coverage to avoid a penalty
Returning to Work After Retiring?
If you retire, then later decide to go back to work with an employer that offers employer insurance, be sure carefully explore all of your health coverage options. Compare your new employer’s plan to Medicare coverage before making your final decision.
If you decide to go with your employer’s insurance, you can drop your Medicare Part B coverage if you do not need it or want it. However, be sure that your new employer plan is in effect before dropping your Part B coverage.
When you return to Medicare, you will have a 2 month enrollment period to sign up for a plan, (from the time you leave employer coverage) to do so without penalty. You can sign up for a drug plan under the ‘Leaving Employer Coverage’ Special Enrollment Period (SEP).
You will have 63 days to apply for a Medicare Supplement plan without any health questions asked.
Not Sure What Option Is Best for You?
Give us a call and speak with a licensed agent today. We can help you see which option would be best for your situation! 1-(888)-321-6361
