Medicare vs work insurance as primary
Some people have insurance coverage through both their employer/group plan and through Medicare. When this is the case, the question comes up about which is the primary insurance which is what we will answer for you in our Medicare vs work insurance as primary blog.
If you are 65 or over, eligible for Medicare, and have insurance through your or your spouse’s current job, you should still enroll in Medicare Part A. For most people, Medicare part A is free.
In order to decide whether to take Part B (medical insurance), for which most people pay a monthly premium of $134 a month, you should ask your benefits manager or human resources department how your employer insurance interacts with Medicare and confirm this information with the Social Security Administration (SSA). Be aware that when you qualify for Medicare, your employer insurance may start to work differently for you because it may start to pay as the secondary insurance. This is usually the case for groups under 20 employees. When you are over 65 and working for a employer under 20 employees you usually need to purchase Part B of Medicare in order maintain coverage.
As a first step, assess whether your employer insurance will be primary or secondary to Medicare.
- Secondary insurance only pays all or some of the unpaid portion of covered health care expenses only after the primary/main insurer has paid. If your employer insurance will be secondary to Original Medicare, you should generally take Medicare Parts A and B when you are first eligible to enroll.
- Primary insurers pay first. Normally, you do not need Medicare Part B if you have primary employer coverage unless you are unhappy with that coverage. This is usually for an employer group of 20 or more employees. You may still want to evaluate which coverage is a better deal before deciding to waive part B of Medicare
In either case, you qualify for a special election period when you are over 65 and getting coverage while working on your own or through a working spouses coverage. If you drop the group health coverage or stop actively working or a spouse stops actively working, you have an 8 month period to enroll in Medicare part B.