b. Should I keep my existing employer-sponsored plan?

CHOOSE MEDICARE OR EMPLOYER COVERAGE

Which is better? It depends.

• If you are enrolled in an H.S.A. compatible health plan through your employer, you may elect to stay on that plan and defer Medicare Part A & B.
• If you are enrolled in a non-H.S.A. compatible health plan through your employer, you may only enroll in Medicare Part A and defer Medicare Part B.
• In most cases, Medicare coverage is better at a lower cost. In other instances where your employer’s plan would cost you less than Medicare, the employer would prefer to pay your Medicare premiums than the premiums under the employer group health plan. We recommend you approach your employer with a proposal to switch to Medicare, with them paying your Medicare premiums for as long as you are eligible for group health coverage. A win-win for everyone!

When can you change over to Medicare?

• You have until eight months after leaving an employer group plan to join Medicare.
• You have until eight months after stopping work to join Medicare (even if you are still on the group health plan)
• Coverage under COBRA is NOT considered Creditable Coverage under your employer’s group health plan.

But to make the individual decision “Medicare or Employer Coverage” based on your circumstances, we recommend some research first:

FIRST, ASK YOUR EMPLOYER SOME QUESTIONS:

1. Are you required to drop the employer coverage? Or could you delay your Part B enrollment to stay on the employer plan?
2. Is your employer’s prescription drug coverage “Creditable Medicare Coverage”?
3. What is the cost for each family member to be enrolled in the Employer’s Plan? How much might you save if they were not enrolled in that plan?
4. Would the employer contribute to the cost (via a buy-out) of your Medicare coverage if you continued to work but withdrew from the Employer’s plan?
5. Will the employer continue contributing to your existing Health Savings Account if you stay on the Employer’s Plan?

THEN ASK WHEELERS:

1. Could you save money and/or get better coverage with Medicare?
2. If you have family members under 65, what coverage, at what cost, is available in the Individual Market (coverme.gov)?

IF YOU DECIDE TO STAY ON THE EMPLOYER’S HEALTH SAVINGS ACCOUNT COMPATIBLE PLAN:

Do NOT enroll in Medicare Part A OR B at this time. Enrollment in Part A, while free, will disqualify you (or the employer) from making tax-deductible contributions to the Health Savings Account. 

IF YOU DECIDE TO STAY ON THE EMPLOYER’S NON-H.S.A. COMPATIBLE PLAN:

Contact Social Security to Enroll in Part A only. You will refuse Part B now but take it later once the employer coverage ends. You can bill hospital claims to BOTH Medicare Part A AND your employer coverage. 

IF YOU DECIDE TO SWITCH TO MEDICARE AT AGE 65?

Contact Social Security to Enroll in Original Medicare Parts A & B within three months of turning 65. 

IF YOU DECIDE TO SWITCH TO MEDICARE AFTER TURNING 65?

Contact Social Security at least three months before your desired Part B start date and request a Part B Special Enrollment Period.