One of the most frequent questions I get about Medicare is “Do I need to sign up for Medicare when I turn 65 if I have employer group coverage?” And the answer is: It depends….
It depends on the size of the employer group and some other factors:
• Your cost for the coverage (including premium contribution and out of pocket expenses for deductibles, copays and your annual out of pocket maximum)
• If the employer plan benefits meet your needs (benefits, provider network)
NOTE: If your employer group is less than 20 employees, you should sign up for Medicare Part A and Part B when you are first eligible or face a lifetime late enrollment penalty. Your Initial Enrollment Period is a seven month window:
• 3 months prior to your 65th birthday,
• your birthday month and
• 3 months after your birthday month
With employer groups of less than 20 full time employees, Medicare is the primary payer and your employer group coverage pays secondary based on the benefit plan.
If your employer group is more than 20 employees, and offers medical and prescription drug coverage that is at least as good as Medicare (aka "creditable coverage"), you may not need to sign up for Medicare Part B right away. However, it's important to review the benefits and cost of your employer plan compared to the benefits and cost of Medicare plus a Supplement and drug plan or Medicare Advantage plan. In many cases, people save money by enrolling with Medicare.
There are several options for Medicare Advantage and Medicare Supplement plans available, and the key is determining which one will offer you the best coverage based on your healthcare needs, your lifestyle and your budget.
Medicare agents must be licensed in the state they sell products and must complete an annual certification and insurance company specific product training each year to assure they are qualified to help beneficiaries in making good choices. If you need assistance with your Medicare decisions, please contact me at 206-569-5415 or by email at firstname.lastname@example.org. I am a licensed and certified health insurance agent in WA State and represent multiple health insurance companies. I can help you with your decision and enrollment for the plan that best meets your needs.