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Home / What Happens to My Employer-Sponsored Health Insurance After I Get Medicare?

What Happens to My Employer-Sponsored Health Insurance After I Get Medicare?

Article originally posted April 21, 2023 on www.insuranceneighbor.com(opens in new tab)

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If you have employer-sponsored health insurance and you will soon be eligible for Medicare, you may be wondering what will happen to it once coverage kicks in. The short answer is yes, you can keep both the coverage provided by your employer as well as your Medicare. You can also choose to drop your employer’s health plan, but it is not a requirement. The size of your company will determine which plan will be your primary payer and which will be your secondary payer.

The Impact of Medicare on Employer-Sponsored Health Insurance

If you are still enrolled in your employer’s health insurance and choose to keep it when you become eligible for Medicare, the size of the company you work for will determine each type of payer. Even if you have two payers, it is still possible to have some out-of-pocket expenses.

  • A large company: If you work for a company that has 20 or more employees, it is considered a large company by Medicare. Under these circumstances, the health insurance provided by the large company will be your primary payer, and Medicare is the secondary payer.
  • A small company: If you work for a company that has less than 20 employees, it is considered a small company by Medicare. Under these circumstances, Medicare will be your primary payer, and the coverage from your employer-sponsored health insurance will serve as the secondary payer.
  • You are retired and still receiving coverage: If you still receive health insurance from your employer but are no longer an active employee, Medicare will be your primary payer, whether the company you worked for is large or small.
  • You are under 65 and have a disability: If you are enrolled in Medicare because of a disability, and you also receive health insurance through your employer, your employer’s health insurance will be the primary payer if it has over 100 employees.

If Medicare provides smaller premiums and better coverage than the plan you currently have through your employer, you should consider dropping your employer-sponsored health insurance. However, suppose the health insurance you receive through your employer is excellent. In that case, you might want to delay your enrollment into Medicare or enroll only in Part A since, generally, most do not have to pay a premium for it.

Discuss Your Medicare Coverage to Learn More About How It May Be Affected

Healthcare coverage is important no matter how old you are, but it is especially crucial later in life when you are preparing to retire from your job, which is why you should understand how it works and how it may impact the coverage you have through your employer. You should make sure you choose the right configuration of plans so you have the best coverage at an affordable price.

Connect with a member of our team today to inquire further about your Medicare coverage, how it interacts with your employer-sponsored coverage, and if you should postpone enrollment.

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