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Medicare & Employer Coverage

With employer coverage, you may wonder if Medicare is even necessary. In some cases, you can wait on enrolling in Medicare without penalty. In other cases, it’s best to have both your employer group health coverage and Medicare!

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Can I Delay Medicare Coverage If I Have Employer Group Health Insurance?

In many cases, you can. This depends on how many employees your employer or your spouse’s employer has (if you’re covered under your spouse’s plan). For employers who have 20 or more employees, you can delay Medicare enrollment and wait until your coverage ends before obtaining a policy.

Once your employer coverage ends, you have eight months to sign up for Medicare without incurring penalties.

For employers with fewer than 20 employees, you’ll need to sign up to avoid late enrollment penalties. Late enrollment penalties work differently depending on the type of plan you choose. These are the plans within Medicare, durations of penalty payments, and how those penalties are calculated:

How Do Medicare And Employer Group Health Insurance Work Together?

When you have both, your two policies will help cover your expenses in an order instead of both at once. The policy that pays first is the primary payer, and the one that pays second is the secondary payer. Here is how this works based on the number of employees your employer has:

  • If your employer has fewer than 20 employees, Medicare is the primary payer.
  • If your employer has 20 or more employees, your employer insurance will be the primary payer.

We Can Help You Find The Right Coverage

At Toni Buffington Medicare Solutions, you are well on your way to the best savings. We are with you every step of the way so that you don’t miss out on great coverage!