At age 65, are you Better off on an Employer Plan or Medicare?

Whether or not you continue to work after age 65, you can still get Medicare. Most people should enroll in Medicare Part A when they become eligible, even if they are covered under an employer sponsored plan. Medicare Part A (hospital) covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and care provided by hospices. Part A is free for most people. Medicare Part B (medical) covers most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. Part B has a monthly premium that may change each year (currently it is $134.00 a month). Part B premiums may be higher for some people if their yearly income is above a certain amount as reported on their tax returns.

If you are Medicare eligible, it may be helpful to perform an analysis to determine if it would be more cost effective to drop your group plan and take Medicare (Part A and B), along with a Medicare supplement or cost plan, and a Medicare prescription Plan (Part D). Although you can remain on your employer group health plan, it might just make better financial sense for you to be on Medicare.

Here are some things to consider when deciding if you should stay on your employer group health plan or enroll in Medicare.

  1. Average out-of-pocket costs. These include the premiums deducted from your paycheck and the member liability you pay when incurring medical or prescription drug claims.
  2. Max out-of-pocket costs. While your current medical needs may not be requiring them to pay much out of pocket, all plans have a maximum out-of-pocket cost which you could be facing in future years in the event your medical needs change.
  3. Effects on dependents covered under their plan. If you choose to elect Medicare instead of our employer group health plan, you will no longer be able to cover your spouse or dependent children, if applicable.
  4. Tax effects. While your employer group health plan premiums are pre-tax, premiums you pay for Medicare are not.
  5. Benefits Medicare does not cover. Some employer group health plans may cover additional benefits that Medicare does not cover, like eyeglasses.

To learn more about our top-rated plan, click here for a schedule of our monthly Medicare meetings, where a plan representative will be available to present you with plan information and applications. Walk-ins are welcome at our Dubuque office, located at 1605 Associates Dr., Monday through Friday, 8:00 a.m. to 5:00 p.m.


Y0045_MAHP_892 CMS Accepted 08272017

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