If you have insurance coverage through your employer, it can affect your eligibility for Medicare and how Medicare works for you. Here are some key points to consider:
- Medicare Eligibility: Most people become eligible for Medicare at age 65. If you have insurance coverage through your employer and plan to continue working past the age of 65, you may delay enrolling in Medicare Part A and/or Part B without incurring penalties. This is because your employer-provided coverage is considered creditable coverage, and you can typically enroll in Medicare during a Special Enrollment Period (SEP) when you or your spouse’s employment ends or your employer coverage ends.
- Coordination of Benefits: If you have both employer-sponsored insurance and Medicare, your employer coverage is typically considered the primary payer, and Medicare is the secondary payer. This means your employer coverage will pay first, and Medicare will pay secondary to cover costs that your employer plan doesn’t.
- Employer Size: The rules for how Medicare coordinates with employer coverage can vary based on the size of your employer. If your employer has 20 or more employees, Medicare is usually the secondary payer. If your employer has fewer than 20 employees, Medicare is generally the primary payer, and you may be required to enroll in both Medicare Parts A and B when you become eligible.
- HSA and FSA: If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA) through your employer, there are specific rules and restrictions regarding contributions and the use of funds after enrolling in Medicare. It’s important to understand these rules to avoid any tax-related issues.
- Medicare Part D (Prescription Drug Coverage): If you have prescription drug coverage through your employer, you should evaluate whether it’s creditable prescription drug coverage. If it is creditable, you may be able to delay enrolling in Medicare Part D without incurring late enrollment penalties. Your employer can provide this information.
- Retiring or Losing Employer Coverage: When you retire or lose your employer-sponsored coverage, you can typically enroll in Medicare without penalties during a Special Enrollment Period. It’s important to do this within the specified time frames to avoid gaps in coverage.
It’s essential to discuss your specific situation with your employer’s benefits administrator and with Medicare to understand how your employer coverage will interact with Medicare. It’s also a good idea to consider your individual health needs and financial circumstances when making decisions about when to enroll in Medicare. Pinnacle Insurance Services can answer all your Medicare questions at 816-477-0180 or email us at [email protected]
