To answer on the question “Medicare and Current Employer Insurance – How it works?” you need to know first whether Medicare is primary or secondary insurance. If Medicare is primary, then it pays the bills first, up to the limit of its coverage. The secondary insurance pays only after Medicare paid its share. If Medicare is secondary, then it pays after the primary insurance paid. If you do not have primary insurance, the secondary insurance will cover very little of your health expenses, or nothing at all. See more in When Medicare is Primary Insurance.
Medicare and Current Employer Insurance – Primary and Secondary Insurance
If you are still working:
Medicare is the primary insurance if:
- You 65 or older, entitled to Medicare and covered by a group health plan because you or your spouse is still working, AND the employer has less than 20 employees
- You are disabled entitled to Medicare and covered by a large group health plan from your work, or from a family member who is working, AND the employer has less than 100 employees
Medicare is the secondary insurance if:
- You 65 or older, entitled to Medicare and covered by a group health plan because you or your spouse is still working, AND the employer has 20 or more employees
- You are disabled entitled to Medicare and covered by a large group health plan from your work, or from a family member who is working, AND the employer has 100 or more employees
Medicare is primary insurance and pays first:
- If you are covered by Medicare and Medicaid. Medicaid is secondary insurance.
- If you have Medicare and employer group health plan after you retire, Your secondary coverage is your Retiree Coverage
- If you have Medicare and COBRA coverage. Your secondary coverage is your COBRA.
Medicare and Current Employer Insurance – Should you delay Medicare Enrollment?
If Medicare is the Primary Insurance:
- You should NOT delay Medicare enrollment, because your employer insurance plan (being secondary insurance) may refuse to make payments until Medicare pays
If Medicare is the Secondary Insurance:
- You may delay Medicare enrollment without penalty. Typically it means delaying the Part B enrollment, but not Part A. Part A (Hospital Insurance) is free for most of the people, but you need to pay premium for Part B (Medical Insurance). The standard Part B premium is $121.80.
- You may enroll in Medicare at any time while being covered by your current employer insurance, or up to eight months after you lost the employer coverage. The Special Enrollment Period will allow you to enroll in Medicare without delay and without penalty. You also will be entitled to enroll in a Medicare Advantage or Medicare Supplement plan, as well as in Prescription Drug plan.
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For help finding the best Medicare or Individual Health Plan for you, please contact Liberty Medicare or call us at 877-657-7477.