Turning 65 With Employer Health Coverage
When you turn 65, it is always a good idea to enroll in Medicare Part A, since there is not a premium for most people. An exception to this, would be if you are contributing to a health savings account and would like to continue doing so, since you are not allowed to contribute to an HSA once you are on Medicare. However, Part B does have a premium, and if you already have health coverage, you need to decide whether it makes sense to discontinue your current insurance or not.
The best place to start is to call your benefits administrator at your place of work. They will let you know how turning 65 will affect your current coverage. There may be no change at all, or you may be required to go on Medicare. There are many complex rules involved here, especially depending on the size of the company.
If your employer has fewer than 20 employees, Medicare will pay first. In this case you would want to sign up for Parts A and B; if you did not, your plan will not pay the cost of what Medicare would have paid. If your employer has more than 20 employees, your health coverage stays the same. You would then decide whether to stay on the employer plan or go on Medicare Part B.
Items to consider when comparing your employer plan to Medicare:
- Do you have a spouse that is covered under your insurance?
- What is the premium you are paying?
- What is your deductible?
- What are your copays and coinsurance?
- What are your maximum out-of-pocket expenses?
- How complete is your drug coverage?
- Are you restricted to a provider network?
There may be other things you would need to consider as this is not a complete list. There is a lot involved here, and you should seek assistance. Should you decide that it makes more sense to go on Medicare, if you change your mind, you may not be able to go back to your previous coverage.
Should you decide to drop your employer coverage after comparing, you would enroll in Medicare Part A and B, and then choose what additional coverage suits you best.
Where to Go with Questions
If you have questions about who pays first, or if your coverage changes, call the Benefits Coordination & Recovery Center (BCRC) toll-free at 1-855-798-2627. TTY users can call 1-855-797-2627.
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