Skip to content

Do I Need Medicare If I Have Other Health Insurance?

2013 May 30

P.Muschler-blogBy Paula of Allsup

What happens if you’re about to become eligible for Medicare plans—but you already have health insurance through an employer, a spouse’s employer or a retiree plan? Do you need to enroll in Medicare, or can you just keep the coverage you have now?

Medicare’s rules can be confusing. Here are three common situations many Allsup customers face:

  • I’m about to turn 65 and still working. I have health insurance through my employer. Do I have to sign up for Medicare?

Most people don’t pay a premium for Medicare Part A, which helps cover hospital stays. There’s usually no reason not to sign up for this coverage as soon as you’re eligible. With Part B, which covers doctor visits and other outpatient care, you’ll pay a monthly premium. If you like your current plan, it may make sense to keep it and wait to sign up for Part B when you retire.

If you decide to delay Part B, contact Social Security to find out how to avoid a late-enrollment penalty. Also, be aware that Medicare’s rules are different if you work for a very small employer. If your employer has fewer than 20 employees, your employer may require you to sign up for Medicare Parts A and B when you’re eligible.

  • I receive Social Security Disability Insurance benefits and will soon be eligible for Medicare. I currently have health insurance through my spouse’s employer. Should I sign up for Medicare?

This situation is similar to the first one. In most cases, it makes sense to go ahead and enroll in Part A if you’re not paying a monthly premium. But if your spouse’s insurance provides excellent coverage with low out-of-pocket costs, then you might consider staying on this plan and waiting to enroll in Part B.

One important thing to note, though, is that Medicare defines a “small employer” differently for people who are eligible for Medicare based on disability. If your spouse’s employer has fewer than 100 employees, the employer may require that Medicare pay first on your claims. In this case, you’ll need to take Medicare Parts A and B as your primary insurance.

  • I am eligible for a retiree plan with my former employer. Do I need Medicare too?

Retiree plans typically require you to sign up for Medicare plans as soon as you’re eligible. Then, Medicare pays first on your claims, with your retiree plan picking up only those costs that Medicare does not cover.

In any of these situations, be sure to speak with the administrator of your health plan to confirm how your benefits will work with Medicare. If you have questions about Medicare’s rules for delaying coverage or coordinating benefits, you also can contact a Medicare plan expert at the Allsup Medicare Advisor® at (866) 521-7655.

8 Responses leave one →
  1. Ken Dillon permalink
    July 9, 2013

    I have VA health benefits, do I need to enroll in Part B when I become eligible?

  2. September 21, 2015

    This is a good tip particularly to those new to the blogosphere.
    Simple but very precise information… Many thanks
    for sharing this one. A must read article!

  3. January 12, 2018

    Wοrking as a contrsct parallegal has components in its faѵor, and components which might bee negative to some people.
    If a waaʏ of journeʏ annɗ excitemеnt in your ᴡork lfe is what
    would go well with you the veey best, freelancing might be an amazing option for yoս!

  4. January 24, 2018

    Unquestionably believe that which you said. Your favorite justification appeared to be on the net the simplest thing to
    be aware of. I say to you, I definitely get irked while people consider worries that
    they plainly do not know about. You managed to hit the nail upon the top
    and also defined out the whole thing without having side-effects , people can take a signal.

    Will likely be back to get more. Thanks

  5. January 30, 2018

    I always used to read article in news papers but now as I am a user of net therefore from now I am using net for
    posts, thanks to web.

  6. February 24, 2018

    Hi! Great content articles here. please do keep us updated.

  7. February 25, 2018

    Por que isso é fundamental? Comprar, assinar, aprender algo).

Leave a Reply

Note: You can use basic XHTML in your comments. Your email address will never be published.

Subscribe to this comment feed via RSS