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If you are turning 65 years old and have Employer Health Insurance do you still need to enroll in Medicare

When it comes to healthcare coverage, there are many options available to individuals. Some are provided by employers, while others are government programs like Medicare. So, if you have employer insurance, do you still need Medicare? Let’s take a closer look at the details to find out.

Employer Insurance vs Medicare

Employer insurance is provided by an employer as a benefit for their employees. It can come in the form of a group health plan or individual coverage options. Employer insurance plans typically offer comprehensive coverage and a range of benefits, including medical, dental, vision, and prescription drug coverage.

On the other hand, Medicare is a government-run health insurance program designed to provide coverage to individuals aged 65 or older, as well as those with certain disabilities. Medicare is also available to individuals under 65 with end-stage renal disease or ALS. Medicare coverage is divided into four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage).

When You Don’t Need Medicare

If you are still working and have employer insurance, you may not need Medicare. If your employer insurance covers you and your dependents, it can serve as your primary coverage. However, it’s important to know that employer insurance is only considered primary if your employer has 20 or more employees. If your employer has less than 20 employees, Medicare will be your primary coverage.

When You Need Medicare

Even if you have employer insurance, you may still want to enroll in Medicare if you are eligible. There are several reasons why you may need to enroll in Medicare, including:

Your employer insurance may not cover certain medical expenses that Medicare covers, such as long-term care or skilled nursing facilities.

If you retire, your employer insurance coverage may end. Enrolling in Medicare can help ensure that you have continuous coverage.

Medicare may provide more comprehensive coverage than your employer insurance. For example, Medicare Part D provides prescription drug coverage, which may not be included in your employer insurance plan.

Enrolling in Medicare

If you are eligible for Medicare and decide to enroll, you will need to do so during your Initial Enrollment Period. This period begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. If you miss this enrollment period, you may have to pay a late enrollment penalty and may have limited enrollment options.

Health Insurance Cost vs Medicare Cost

You should compare cost before deciding which options is best for you as far as coverage that meets your health needs and the cost associated with those medical needs. From monthly cost of having coverage, doctor visits, cost for medications, emergencies, hospitalizations, and other health services.

Option 1 – Keep Employer Health Insurance and enroll in Medicare Part A (covers hospital). 

For most Medicare Part A is free to have if you have 40 credits. When you disenroll from  Employer Health Insurance due to cost or you retire then you can enroll in Medicare Part B. 


Option 2 – After you compare your Employer Health Insurance to Medicare (Part A + Part B + Part D + Supplemental Plan) and determine you have better coverage with Medicare then at 65 years old you enroll in Medicare.



Whether or not you need Medicare if you have employer insurance depends on several factors, including the size of your employer and the coverage provided by your employer insurance. If you are still working and have comprehensive employer insurance, you may not need Medicare. However, if you are eligible for Medicare and have concerns about your employer insurance coverage, enrolling in Medicare may be a good option for you.

To learn more about Medicare visit www.medicare.gov


Give me a call and I can help with your questions about Medicare and compare your Employer Health Insurance vs Medicare.

New to Medicare

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