Medicare & Employer Coverage

Medicare and employer coverage do not have to be mutually exclusive. Together, they can help you in getting what you need with minimal out-of-pocket costs left over.

Interested in learning more?

How they work together

In the majority of cases, Medicare complements your employer coverage nicely. Even if your employer’s health plan saves you on the bulk of your medical expenses, adding Medicare to your plan is a hassle-free option that can effectively reduce many of your out-of-pocket costs to $0.

Here’s how it works – Medicare and your employer’s health insurance coordinate who pays first according to how many employees your employer has, given other circumstances. And this doesn’t have to be coverage from your employer, the same applies if you are getting employer health insurance from your spouse’s employer.

If your employer has fewer than 20 employees, then Medicare pays what it can, and then the employer insurance will cover what it can of the rest.

If your employer has at least 20 employees, your employer insurance pays first.

The order of insurance payment and number of employees required works differently if you are under 65, and disabled. If your employer has at least 100 employees, then the employer plan pays first. If under 100 employees, Medicare pays first.

If you get employer health insurance from your own or family member’s employer, and you are eligible for Medicare because you have End-Stage Renal Disease (ESRD), then the group health insurance pays first for the initial 30 months, and after that, Medicare becomes the first to pay.

Why you should check with your insurance first

Always check before getting on a Medicare plan while you have employer health insurance coverage. Most of the time, it’s going to be fine and you can have both. But, in some instances, such as joining Medicare Advantage, joining could make you lose your employer health insurance, and you may not be able to get it back. The same can happen when joining Medicare Part D.

If you’re already satisfied with your employer coverage

Although you are able and encouraged to join Medicare when you’re first eligible, you can still delay enrollment without facing late enrollment penalties.

The Medicare program accounts for those who already have employer coverage and do not need other forms of health insurance at the time. The Medicare Special Enrollment Period takes this into consideration. With this, if you lose your employer health insurance coverage, you have an eight-month window to join Medicare, beginning the month after you no longer have employer health insurance.

We’ve got it from here

Medicare With Jake is an insurance agency based in Wichita, Kansas, that brings you the ability to experience the best of both worlds. Why choose to be happy with one when you could be happier with both? We see to it that you get better coverage than you thought possible. Sometimes, something being too good to be true is in fact true, and what better way to find out than right now when you can call us and make your reduced medical costs even lower.