65 and Still Working: Medicare or Group Plan?


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The population of adults 65 and up staying in the workforce continues to grow. These employees are then required to decide between continuing with their employer-sponsored insurance or sign up for Medicare. We will consider the possibilities and determine if one of the options is “better”.

More Than 20 Employees

If an organization has at least 20 employees and you or your spouse have been actively working with the company, after you turn 65, you can put off your enrollment into Medicare until the employment ceases or coverage ends. You can enroll at a later time without incurring any late fees. Once the coverage ends, you are given an 8-month special enrollment period to sign up for Medicare.

It is very important to understand that “active employment” does not involve those receiving retiree benefits or COBRA benefits. You must actually be working for the company to receive the delay in Medicare enrollment.

Three options are entirely up to you as an employee. You can stay with the employer health plan and delay Medicare enrollment, abandon employer health coverage and register for Medicare, or keep both employer and Medicare at the same time. If the last option is for you, you would have to consider that the employer health plan would be primary, meaning that the employer coverage would take care of what it can first before Medicare would kick in to cover the remaining amount. Therefore, there may be no benefit in paying a monthly premium for a Medicare plan that gets little to no use.

Less Than 20 Employees

The laws for larger and smaller employers differ quite a bit. Instead of leaving the choice to Medicare-eligible employees to sign up for Medicare and leave their employer plan, employers with less than 20 employees can decide what their employees do.

Since it is the employer’s decision, they can decide whether or not the employee needs to enroll in Medicare. If they decide to enroll the employee, Medicare will become the primary plan and employer coverage will fall into second place. This means that Medicare will take care of what it can at first and then the group plan will cover what Medicare did not. As a result, if you fail to enroll in Medicare when a company requires it, you could be left with no coverage.

Weighing Your Options

Contrary to popular belief, you may be able to get better coverage at a lower cost with Medicare as opposed to an employer health plan. In recent years, we have seen health care premiums skyrocket, which has prompted employers to place higher deductibles and copays onto their employees. If you are over 65, you may be able to reduce your out-of-pocket costs by dropping your employer’s health insurance plan. Usually, most people do not pay premiums for Part A, and Part B premiums are pretty low. This means that you can receive better coverage for your needed services.

It will take time and research to be able to determine the best option for yourself. Compare and contrast the price and coverage of health insurance and Medicare to pick the right choice.

Health Insurance Questions?

We hope this information on 65 and still working is helpful. 

Empower Brokerage wants to help you understand the insurance coverage you need and how to save money getting it. Stay on top of your health and give us a call at (844) 410-1320

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About Kayla Gonzalez

Kayla is a graduate of Texas A&M University and joined the Empower Brokerage marketing team in early 2021. She creates content for the company websites and assists with various marketing campaigns. LinkedIn Profile

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