Approaching Medicare is confusing, but it’s even more complicated for people who plan to work after 65, or people who have health insurance through an employer after their 65th birthday.
As a recap, the rule says:
By the time you turn 65, you either need to be on Medicare or be covered under an acceptable health insurance plan. If you don’t meet the rule, you will face penalties.
In another blog post, I covered the three attributes that must be true for your plan to meet Medicare rules. If your plan meets Medicare rules, you need to decide if you are better off staying on the employer plan or joining Medicare. For more information, click here to read that blog.
Now, when looking at your options, there are a few key things to consider:
Cost
To know which is better, your employer plan or Medicare, you need to compare your plan side-by-side with Medicare. That includes comparing the premiums, deductibles, co-pays, and max out-of-pocket costs. You should also look at your prescription drug cost on both options. This is a significant factor for people on multiple or expensive medications.
Family Members
If you have family members on your employer plan, you may decide to stay on the employer plan until your spouse or family members are either eligible for Medicare or find other health insurance. Most of the time if your employer provides health insurance, your family will lose coverage when you leave the plan.
Business Owners
Business owners have options to save both themselves and their company money when it comes to deciding between staying on your company plan versus joining Medicare.
My usual recommendation is that if you are paying more than $250 a month per person in premiums and your max out-of-pocket is $2,000 or more; then you need to look at the numbers to decide if Medicare or the employer plan is best for you.
We frequently do this analysis for our clients to help them understand the plan and cost differences so that they can make the best decision.
Please know, if you decide to delay your Medicare enrollment, you don’t need to do anything now as long as you aren’t drawing Social Security. However, you will need to fill out a form when you leave your employer plan and join Medicare.
Medicare is complicated but it doesn’t have to be. To easily make the right Medicare decision, you can CLICK HERE to sign up for our Medicare Enrollment Concierge.
