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Balancing Employer Healthcare & Medicare

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I qualify for Medicare next year and I plan to continue working so my wife who is younger than me can have health insurance. But how does it work for me if I have an employer plan and I qualify for Medicare? 

 Thank you for your question.  My recommendation is to speak with your benefits administrator to make sure you will be able to maintain the group’s plan after turning 65.  Some employer groups require you sign up for Medicare parts A & B and still allow you to maintain group coverage; others will allow you to stay on their plan and maintain status quo.  There are employers that will require you to get off the group plan completely.  If this is the case, you will need to sign up for Medicare Part A & B and add a Medicare Supplement and Part D prescription plan to cover the gaps.

Generally under Medicare rules if you are covered by an employer group with 20 or more employees, you do not have to sign up for Medicare part B; you will have a Special Enrollment Period (SEP).  Medicare beneficiaries who qualify for a Special Enrollment Period can enroll in Medicare Part B without incurring a late-enrollment penalty while they are still employed or their spouse is still employed and up to eight (8) months after they no longer have employer coverage.  For Part D Prescription drug coverage and Medicare Advantage, you will be given a grace period of only 63 days after group coverage ends to sign up.

You may want to sign up for Part A when you first become eligible for Medicare even if you continue working, the reason is that it may offer better coverage for hospitalization than your employer group plan.  Part A is usually free to you but check with your benefits administrator.  If your employer group plan is a high-deductible health plan paired with a health savings account, and if you want to keep contributing to the health savings account (HSA), you should NOT sign up for Part A. The reason is that once you enroll in Medicare, your HSA contributions must stop. 

Please call us if you need assistance with Medicare Supplements, Medicare Advantage or Prescription Part D plans. Our number is (973) 325-7500