There is a continuously growing population of 65-and-ups remaining in the workforce. These employees need to decide whether they will continue with their employer-sponsored plan or sign up for Medicare. In this article, we will consider what the possibilities are and if either is the better option.
More Than 20 Employees
If there are more than 20 employees in a company, and the individual or their spouse has been actively working with the company, they can delay enrollment into Medicare until employment ceases or coverage stops. They can enroll at a later time without sustaining any late penalties. After the coverage ends, the individual would have an 8-month special enrollment period to sign up for Medicare.
It is important to understand that “active employment” does not encompass retiree benefits or COBRA benefits. They must actually be working for the company to delay Medicare enrollment.
It would be solely the employee’s choice to stay with the employer health plan and delay Medicare enrollment, leave employer health coverage and sign up for Medicare, or have employer coverage and Medicare at the same time. If the ladder is their choice, they would need to consider that the employer health plan would be primary. Meaning that the employer coverage would first take care of what it can and then Medicare would cover the remaining amount. So, there may not be any benefit in paying for a Medicare plan that gets little to no use.
Less Than 20 Employees
The laws differ for smaller employers. Instead of being prohibited from requiring Medicare-eligible employees to sign up for Medicare and drop the employer plan, smaller employers get to decide how to handle these employees’ health insurance needs.
The employer may decide that the individual needs to enroll in Medicare. If that is the case, Medicare would become the primary plan and the employer would become a secondary plan. This means that Medicare would first take care of what it covers and then the group plan covers what Medicare does not. So, if the individual fails to enroll in Medicare when required, they can be left with no coverage.
Weighing the Options
Contrary to popular belief, an individual may get better coverage at a lower cost with Medicare as opposed to an employer plan. In recent years, health care premiums have skyrocketed, which has caused employers to place higher deductibles and copays onto their employees. Employees over 65 may reduce their out-of-pocket costs by abandoning their employer’s health insurance plan. Since most people do not pay premiums for Part A, and Part B premiums are quite low, they could get better coverage for needed services.
Ultimately, it takes time and research to determine the best option for oneself. Comparing the price and coverage of employer health insurance and Medicare is the only way to make the right decision.
We hope this information on 65 and still working is helpful to you.
Empower Brokerage is dedicated to helping you educate your clients on the insurance they need and staying on top of their health. Whether it’s through webinar training, one-on-one calls, seminars, or marketing plans. We want you to be successful. Give us a call if you have any questions 888-539-1633.
Kayla is a graduate of Texas A&M University and joined the marketing team at Empower Brokerage in early 2021. She creates content for the company websites and assists with various marketing campaigns. LinkedIn Profile