Medicare vs.
Employer Insurance
You Have Many Options With Medicare vs. Employer Insurance
Within Medicare, there are several styles of plans and coverage types. Medicare Parts A and B (Original Medicare) make up the federal program that covers emergency and preventative care, as well as medically necessary services and supplies—such as hospital stays, doctor visits, and durable medical equipment (DME). It does not include coverage for dental, hearing, vision, or prescription drug coverage.
Medicare Advantage Plans (Part C) are offered by private insurance companies that are monitored by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees Medicare. Part C Plans include everything covered in Parts A and B, and many Medicare Advantage Plans also include prescription drug coverage. Medicare Advantage Plans often cover a variety of additional benefits not included in Original Medicare.
Stand-alone prescription drug plans (Part D) are also available, as well as Medicare Supplement Plans that help cover the copays and other costs related to Original Medicare.
Medicare plans are offered by many well-respected private insurance companies, so with Medicare you have the opportunity to compare and shop plans. With your employer health plan, you probably only have one option, or perhaps a few options from one insurance carrier, so you’re not seeing a wide scope of comparison.
You May Be Able to Get More Benefits
Similar to Original Medicare, many employer health plans may have somewhat limited benefits. Medicare Advantage Plan benefits have consistently expanded over the years, with a collection of standard benefits and more unique and specific benefits when you dig deeper.
According to research by The Kaiser Family Foundation, at least 97% of Medicare Advantage Plans include these benefits in 2024:
According to that same research, 89% of Medicare Advantage Plans in 2024 include an over-the-counter benefit, which provides money for purchasing health supplies at a grocery store or drugstore. Commonly covered supplies include things like bandages, allergy medicine, nutritional supplements, and more. Further, while most insurance premiums increase on a yearly basis, Medicare Advantage Plans are currently trending with some of the lowest premiums in the past decade. Due to the rise in $0 premium plans, you may even be able to gain benefits at no additional cost.
Plans and Benefits Change Every Year
Even if you’re enrolled in your employer’s health plan and you have been happy with it, it’s a good idea to review it every year. Carriers may change plans and benefits every year, so there may be new plan options available in your area that include benefits that are important to you.
Frequently Asked Questions
If you’re still working at 65 or older, you can enroll in Medicare or delay your Medicare benefits and remain on your employer insurance. You can also have both Medicare coverage and insurance from your employer.
Yes, you can keep both employer health insurance and Medicare. Your Medicare coverage will typically kick in after your employer insurance pays out.
Enrollment Eligibility
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
Special Enrollment Period (SEP)
You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.
Further Reading:
e-TeleQuote Insurance Inc. (“e-TeleQuote”) does business as easyMed Insurance Services in all states other than New Mexico. e-TeleQuote is a duly licensed insurance agency appointed by Medicare Advantage HMO, PPO and PFFS plans and stand-alone prescription drug plans and insurance companies holding Medicare contracts approved by The Centers for Medicare & Medicaid Services (CMS). e-TeleQuote is not connected with or endorsed by the U.S. Government or the Federal Medicare Program. Enrollment in any plan for coverage is subject to insurance company approval. Enrollment in the plan depends on the plan’s contract renewal with Medicare. By using e-TeleQuote’s easyMedicare website, you understand and agree that in New Mexico, we operate as e-TeleQuote Insurance, Inc. (Your IP address and/or location coordinates may be gathered to verify your location.) Sales agents may be compensated based on your enrollment in a health plan. Medicare Supplement plans are not connected with or endorsed by the U.S. Government or the Federal Medicare program. e-TeleQuote complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. easyMedicare.com is a non-government site, powered by e-TeleQuote Insurance, Inc. e-TeleQuote provides a secure way to purchase Medicare insurance from the comfort of your home or workplace. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare (TTY users should call 1-877-486-2048) 24 hours day/7 days a week, or your local State Health Insurance Program (SHIP), to get information on all of your options. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.
Last Updated: September 30, 2024
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