Employer coverage can coordinate with Medicare in a variety of ways. If you are an employer and have employees still actively working and also turning 65, you or your employee may need some help in determining how Medicare will coordinate with y0ur group health plan, which parts of Medicare the employee needs for this coordination to work, and/or whether the employee might be be better off to opt for Medicare as their primary insurance and set up a private secondary such as a Medicare supplement.
Here’s a few pointers about employer coverage with Medicare:
- Employers must offer the group same group health coverage to full-time Medicare beneficiaries as they offer to other employees
- If you have more than 20 employees, your group health plan will generally be primary, and Medicare will be secondary coverage. In this scenario, if the group insurance is affordable for the Medicare beneficiary, he or she may opt not to enroll in Medicare Part B, because Part B has a monthly premium they must pay, and if they have group insurance servicing as primary insurance, they may not get much benefit from Part B. The employee can delay enrollment into Part B without penalty as long as he or she maintains health coverage that is equal or better than Medicare’s coverage
- If you have less than 20 employees, then Medicare is going to be the primary coverage for your employee. The employee may opt to stay enrolled in your group insurance as a secondary to Medicare, but many carriers will pay as if the employee is enrolled in both Medicare Parts A & B. It’s important for your employee to check with the group health carrier to determine whether this is the case, so that they don’t miss enrolling in Part B during their open enrollment window.
- Sometimes the cost of group coverage is high and perhaps deductibles are also high – in these cases, it makes sense for your employee to consult an insurance agency like ours that specializes in Medicare insurance products. We can help them analyze their costs for either option and make a good decision as to whether they should remain on your company health plan or change to Medicare primary.
To learn about which insurance will pay first, you can check out Medicare’s publication about Medicare coordination with Employer health plans.
A Boomer Benefits licensed insurance agent can advise you on your questions relating to Medicare coordination of benefits with group health plans. Contact a friendly knowledgeable agent today for assistance.