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 Avalere Health and The Kaiser Family Foundation, at least 97% of Medicare Advantage Plans include these benefits in 2023:
According to that same research, 87% of Medicare Advantage Plans in 2023 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.
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.
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Last Updated: November 1, 2022 MULTIPLAN_ETQEZMwebsite_0722_M