How Does Medicare Work with My Other Insurance?

How Does Medicare Work If I’m Still Working Past Age 65?

How Does Medicare Work with My Other Insurance?

What if you’re still working at age 65? That’s okay, most individuals nowadays are working and receiving health insurance through their employer. So you may be wondering, “How does medicare work with my other insurance?​”

When you are eligible for Medicare and still have group health insurance, you can be covered by both; your “primary payer” insurance (usually your employer insurance) will pay first and your “secondary payer” (usually your Medicare plan) will cover the remainder.

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Are you working past age 65, or getting ready to retire?

Generally if you have job-based health insurance through your (or your spouse’s) current job, you don’t have to sign up for Medicare while you (or your spouse) are still working. You can wait to sign up until you (or your spouse) stop working or you lose your health insurance (whichever comes first).

A couple of notes:

  • If you’re self-employed or have health insurance that’s not available to everyone at the company: Ask your insurance provider if your coverage is employer group health plan coverage (as defined by the IRS.) If it’s not, sign up for Medicare when you turn 65 to avoid a monthly Part B late enrollment penalty.
  • If the employer has less than 20 employees: You might need to sign up for Medicare when you turn 65 so you don’t have gaps in your job-based health insurance. Check with the employer.
  • If you have COBRA coverage: Sign up for Medicare when you turn 65 to avoid gaps in coverage and a monthly Part B late enrollment penalty. If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up.

How does Medicare work with my job-based health insurance?

Remember, most people qualify for part A without having to pay a monthly premium. If you qualify, you can sign up for Part A coverage starting 3 months before you turn 65 and anytime after you turn 65 — Part A coverage starts up to 6 months back from when you sign up or apply for benefits from Social Security.

If you have a Health Savings Account, you and your employer should stop contributing to it 6 months before you sign up for Part A (or apply to receive Social Security benefits) to avoid a tax penalty.

Let’s take a look at this quick sheet:

I’m still working and…How my coverage works with Medicare (Part A & B)
My (or my spouse’s) job has less than 20 employees

Medicare pays for services first, and your job-based insurance pays second.

If you don’t sign up for Part A and Part B, your job-based insurance might not cover the costs for services you get.

Ask the employer that provides your health insurance if you need to sign up for Part A and Part B when you turn 65.

My (or my spouse’s) job has more than 20 employees

Your job-based insurance pays first, and Medicare pays second.

If you don’t have to pay a premium for Part A, you can choose to sign up when you turn 65 (or anytime later).

You can wait until you stop working (or lose your health insurance, if that happens first) to sign up for Part B, and you won’t pay a late enrollment penalty.

I (or my spouse) get a stipend from my employer to buy my own health insurance OR I (or my spouse) am still working, but I don’t have health insurance through that job

Generally, Medicare doesn’t work with your insurance.

Once you sign up, Medicare pays first.

Some private insurance has rules that lower what they pay (or don’t pay at all) for services you get if you’re eligible for other coverage, like Medicare.

Ask your health insurance company if you need to sign up for Part A and Part B when you turn 65.

Questions? Call us today! (561) 665-7752.

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