How do the requirements compare?
Employer-sponsored group health insurance requirements are mostly in your employer’s hands. He or she must provide health insurance coverage to full-time employees working a minimum of 30 hours per week. This serves as a benefit to the employer and employees. For the employer, this is a tax write-off. For employees, group health insurance is much more affordable than the alternatives. The insurance company itself is more lenient on premium costs because providing coverage for multiple people poses little risk, as opposed to giving coverage for one individual.
Medicare eligibility is based on age (unless you receive disability benefits for a minimum of 24 months). Your income source isn’t as important. As long as you are 65 or older and your source of income allows you to pay premiums and other costs, you are fine. You can be retired and still receive Medicare benefits.
What makes Medicare the better choice?
Medicare doesn’t require you to work for a particular employer. Once you get Medicare, you have that policy for as long as you live. With employer coverage, there’s no guarantee you’ll have it forever. You can lose it in the blink of an eye.
The other benefit to Medicare is that it allows you to join during a Special Enrollment Period without a late fee if you happen to lose your employer health coverage. That is as long as your employer has 20 or more employees – and even then, you should speak to your benefits manager to see if your coverage meets the IRS’s definition of group health coverage.
After that, you can enroll without penalty. You have eight months to join Medicare Part B. You may also get Part A premium-free. Medicare gives you that option so you can enroll once you’re ready.
Can I have both at once?
If your employer has fewer than 20 employees, you will need to sign up for Medicare once you’re eligible. This not only prevents you from paying late enrollment penalties down the road – it optimizes your coverage, too. Medicare and your group health plan will work together to make your out-of-pocket costs even lower. You may even end up paying nothing at all for certain medical services.
Make the most out of your Medicare eligibility today
Whether you’re enrolled in a group health plan or looking to transition to Medicare, we’ve got you covered. At KBI Solutions, we will help you decide what steps to take when you are weighing options between employer health coverage and your future Medicare plan. No matter where you stand, we’re here to answer your questions and find you a policy you’re happy with. Give us a call today at 254-918-5444.
