To avoid gaps in your health insurance coverage, it’s important to understand when Medicare is your primary insurance and when your group health insurance is primary.
At MBhealth, we know this can be a confusing topic for a person who is still working after 65 and also has group health insurance through an employer. It’s important to understand how these policies work together.
How to Determine if Medicare Is Primary or Secondary Health Insurance
One of the key factors in determining if Medicare is your primary or secondary health insurance is this: who are you working for? If you are self-employed or working for an employer that has fewer than 20 employees, Medicare is your primary insurance. That means that even if you still have group health insurance, you probably should sign up for Medicare in addition to the coverage you have with your employer.
If you happen to be working for an employer that has more than 20 employees, then that group health insurance plan would be primary. A person over 65 who has group health insurance at a company with more than 20 employees does not need to sign up for Medicare.
Medicare Part B Is Optional Medical Insurance Offered by the U.S. Government
When I refer to signing up for Medicare, I’m referring specifically to Part B of Medicare. Part A gets applied to everybody when they turn 65. If you’ve been fully employed through your normal working years, Medicare Part B is the optional coverage for which our government charges a premium. Again, if you work for an employer with fewer than 20 employees, you must sign up for Medicare Part B and pay that premium in addition to your group health insurance premium.
If you work for an employer with more than 20 employees, you do not have to enroll in Medicare Part B. Your group health insurance plan is all that you need until the day you retire. Then you’ll need to sign up for Medicare Parts A and B as your group coverage lapses.
There’s also Medicare Part D which is prescription drug coverage. That is not as big of an issue, whether you have prescription drug coverage from your employer or work for a small employer or a large employer.
How to Get the Right Help to Make Your Best Choices
When you must sign up for Medicare Part B and when it is considered primary or secondary insurance—these are important topics. As you approach 65 or retirement age, it’s important that you understand these points. If you have any questions, give us a call at MBhealth at (314) 544-5400. We’re ready to help.
