Do I need Medicare if I have employer insurance?
Turning 65 and still working
If you are turning 65 years old and will continue to work. Do you need Medicare, if you have employer health insurance? Before you decide you have to consider cost and coverage.
COST
How much is Medicare going to cost you versus your employer health insurance?
Medicare has two parts
- Part A covers hospital services and should cost you $0 if you have 40 points accumulated or at least 10 years working.
- Part B covers Doctor, Laboratory and other medical services. Part B will cost you a minimum of $148.50 in 2021. Visit Medicare.gov to determine how much Part B will cost you.
Doctor visit cost
Medicare Part B covers your Doctor appointments. Medicare only covers 80% of the cost. You pay the 20%. You have 2 options to cover the 20% a Medigap plan or Medicare Advantage. To learn about Medigap and Medicare Advantage. Click here.
Laboratory, X-Rays, MRI and other Cost
Medicare Part B covers these procedures. Medicare only covers 80% of the cost. You pay the 20%. These procedures cost more than a Doctor visit, that means your 20% should cost you a couple of thousands out of your pocket.
You have 2 options to cover the 20% a Medigap plan or Medicare Advantage. To learn about Medigap and Medicare Advantage. Click here.
Hospital Cost
Medicare Part A covers Hospital cost. Medicare only covers 80% of the cost. You pay the 20%. Emergency, Operations, 24 hours stay at Hospital cost thousands, that means your 20% is unlimited.
You have 2 options to cover the 20% a Medigap plan or Medicare Advantage. To learn about Medigap and Medicare Advantage. Click here.
Medication Cost
Medicare does not cover medications. Medicare Part A or Part B does not cover medications. To cover medications you need to purchase from a private company Plan D.
You have 2 options to cover medications a plan D or with a Medicare Advantage plan. To learn about Plan D and Medicare Advantage. Click here.
Coverage
You have several options for coverage.
► Keep Employer Health Insurance and enroll in Medicare Part A.
Medicare and employer coverage will need to coordinate benefits, which means that either Medicare or the employer plan pays first for covered care.
► Keep with your employer coverage and apply for Medicare when you retire past age 65. Keep in mind that being eligible for Medicare doesn’t mean you have to take it. However, you might want to enroll in Medicare Part A (hospital insurance) at age 65, especially if you qualify for premium-free Part A.
To get the best value and health insurance coverage for your situation, learn about your employer coverage costs, and your costs if you apply for Medicare. You’ll need to do a little research to determine the best arrangement for you. I am a licensed Health Insurance and Medicare agent that can help you figure this out.
You can download the Medicare & You guide that explains everything about Medicare from cost, enrollment, penalties, coverage, Medicare Advantage, Medicare Supplement plans, Plan D, and more. Click here.
If you enroll in Medicare and your spouse and/or kids still need health insurance, get a free health insurance quote.