• John Bozer, MBA

I have insurance, do I need Medicare?

Updated: May 24



That's a good question and it's best answered in person so we can address your specific situation. However, to give a very simplistic answer we will assume you are qualified for Medicare because you are turning 65 and you are on your own or your spouse's creditable insurance coverage from an employer. In this case, the size of your employer makes a difference (see below).


Small Employer (less than 20 employees)

Those who are turning 65 and work for a small employer will need Medicare Part A and B because Medicare will become the primary payer and your group health insurance will be secondary. The company size determines who becomes your primary insurer and who is your secondary insurer, as dictated by Coordination of Benefits (COB) rules.


As an employee of a small company with creditable coverage, it's a good idea to check with your employer to find out how your group health plan works with Medicare. Typically, you have the following options:

  1. Cancel your health insurance coverage and switch to Medicare.

  2. Keep your existing coverage and sign up for both Medicare Parts A & B.

Large Employer (20+ employees) If you are satisfied with both the premiums and the benefits of your current insurance, you may not need Medicare Part A or B until you retire. Medicare Part A (hospitalization insurance) is premium-free but Medicare Part B (medical insurance) has premiums. In light of this, we recommend, if you are planning to keep your current group health plan, that you do not sign up for Medicare Part B until you retire. As long as you have creditable coverage through your employer, you will not be penalized for not signing up when you turn 65. If you sign up for Medicare, your current insurance would be the primary payer and Medicare would be the secondary payer. As an employee of a large company with creditable coverage, it's a good idea to check with your employer to find out how your group health plan works with Medicare. Typically, you have the following options:

  1. Keep your existing coverage until you retire.

  2. Cancel your health insurance coverage and switch to Medicare.

  3. Keep your existing coverage and sign up for the premium-free Medicare Part A.

  4. (Not recommended) Keep your existing coverage and sign up for both Medicare Parts A & B.

As you are making your coverage decisions, here are some points to consider:

  1. It is wise to compare Medicare to your group health plan. Keep in mind the premiums, deductible, max out of pocket limits, and the benefits to determine which is best for you.

  2. Take into account the state of your health and your pharmaceutical needs. This may help you decide which option is best for you.

  3. How soon do you plan to retire? If your retirement date is near, the decision is an easy one. It is time to sign up for Medicare.

  4. If your spouse or other dependent is under the age of 65 and is on your group health plan, you may want to keep the group health plan as long as possible to continue to provide coverage for them.

  5. If you do sign up for Medicare, you will no longer be able to contribute pre-tax dollars to a Health Savings Account (HSA).

  6. If you are considering signing up for Medicare Part B, your income is a factor. Medicare Part B premiums are determined by your income.

As mentioned above, this topic is best discussed in person or on the phone. If you would like our assistance, call (941) 315-5801 or click below to schedule a free appointment. We are happy to help you.

 

We provide FREE Medicare Reviews. For existing Medicare clients, an annual review is recommended in the fall of each year near the Annual Enrollment Period. If you are turning 65 and new to Medicare, we can help you with your plan selection during your Initial Enrollment Period. We are here for you!


Your Licensed Medicare Specialist

John Bozer, MBA

Independent Medicare Insurance Representative


PHONE: 941.315.5801 • EMAIL: John@Bozer.biz • WEBSITE: www.Bozer.biz/Medicare

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