Understanding Your Options When You Have Employer-Sponsored Insurance
Subheadings:
What is Medicare, and What are Parts A, B, and C?
Can Medicare be Secondary to Employer-Sponsored Insurance?
Why You Should Meet with a Medicare Broker Before Making Any Decisions
As you approach the age of 65, you may be wondering whether you should enroll in Medicare, or if you can continue to rely on your employer-sponsored insurance as your primary coverage. While the answer to this question can vary depending on your specific situation, it's important to have a clear understanding of your options so that you can make an informed decision.
What is Medicare, and What are Parts A, B, & C?
Before we dive into the question of whether Medicare can be secondary to employer-sponsored insurance, let's review what Medicare is and what its different parts cover.
Medicare is a federal health insurance program that is available to people who are 65 or older, as well as to some people with certain disabilities or health conditions. There are three main parts to Medicare:
Part A (Hospital Insurance): Covers hospital stays, skilled nursing facility care, hospice care, and some home health care.
Part B (Medical Insurance): Covers doctor visits, outpatient care, medical equipment, and some preventive services.
Part C (Medicare Advantage): This is an alternative to Original Medicare that is offered by private insurance companies. Medicare Advantage plans must cover everything that Parts A and B cover, and many also offer additional benefits such as dental, vision, and prescription drug coverage.
Can Medicare be Secondary to Employer-Sponsored Insurance?
Now let's get to the heart of the matter: can you enroll in Medicare and still keep your employer-sponsored insurance as your primary coverage? The answer is yes, in some cases.
If you are still working and have insurance through your employer, you can delay enrolling in Medicare without penalty until you retire or lose your job-based coverage. In this case, your employer-sponsored insurance would be your primary coverage, and Medicare would be secondary. However, if you decide to enroll in Medicare while still working, your employer-sponsored insurance would become secondary, and Medicare would become primary.
It's important to note that there are some exceptions to these rules, and the specifics of your situation may affect your options. For example, if you work for a small employer with fewer than 20 employees, Medicare may be your primary coverage regardless of whether you enroll. Additionally, if you have retiree health benefits through a former employer, your options for Medicare may be different.
Why You Should Meet with a Medicare Broker Before Making Any Decisions
Given the complexity of Medicare and the potential impact on your overall healthcare coverage, it's a good idea to meet with a Medicare broker before making any decisions. A Medicare broker is a licensed professional who can help you navigate the various options available to you and provide guidance on which plan is best suited to your needs.
Working with a Medicare broker can help you:
Understand the costs associated with different Medicare plans, including premiums, deductibles, and out-of-pocket expenses.
Compare the benefits of Original Medicare versus Medicare Advantage plans.
Determine whether your current doctors and healthcare providers are in-network for the Medicare plan you are considering.
Navigate the enrollment process and ensure that you are making the right decisions at the right time.
Conclusion
In summary, the answer to the question of whether Medicare can be secondary to employer-sponsored insurance depends on your specific situation. If you are still working and have
About Preferred Senior Benefits in Meridian, Idaho
Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818-2523. We can’t wait to help you learn about your options.