Deciding Between Employer Plans and Medicare: Should I Postpone Medicare Enrollment?

by | Oct 8, 2023 | Spousal IRA | 43 comments

Deciding Between Employer Plans and Medicare: Should I Postpone Medicare Enrollment?




| (888) 465-9728 | stephanie@abtinsuranceagency.com | Employer Plan vs Medicare – Delaying Medicare can be a difficult decision for some, especially when you don’t quite understand how Medicare coverage will compare to the employer based health plan you have now. If you are working past age 65, or your spouse is working past age 65 and you are covered on your spouse’s employer medical plan, you may want to delay you Medicare coverage all together. However, the decision of whether or not to delay Medicare can depend on several different factors, which I review in today’s video.
Medicare questions? Need a Medicare Plan? Let us help. Our service is 100% free of charge.
888-465-9728

Medicare Supplement Rates:
Medicare Part B Special Enrollment Period Guide:
Who Pays First? Medicare and other coverage:
How to Enroll in Medicare When You Retire:
Medicare Advantage Vs. Medicare Supplement: …(read more)


LEARN MORE ABOUT: IRA Accounts

CONVERTING IRA TO GOLD: Gold IRA Account

CONVERTING IRA TO SILVER: Silver IRA Account

REVEALED: Best Gold Backed IRA


Should I Delay Medicare? Employer Plans vs. Medicare Coverage

As individuals reach the age of 65, many face the crucial decision of whether to enroll in Medicare or continue with their employer-provided health insurance plans. This decision can have long-term financial and health implications, making it important for individuals to weigh their options before making a choice.

One of the primary factors to consider when deciding whether to delay Medicare enrollment is the cost of the employer-provided health insurance plan. In some cases, employer plans may offer better coverage at a lower cost compared to Medicare. If this is the case, individuals may find it more beneficial to delay their Medicare enrollment and continue with their employer plan. However, it is essential to carefully evaluate and compare the coverage and costs of both options before making a decision.

See also  Can My Wife Get Half of My Social Security Benefit?

Another significant consideration is the size of the employer. In general, if an individual works for a large employer with more than 20 employees, the employer-provided health insurance is considered to be the primary coverage, with Medicare acting as secondary coverage. In such cases, delaying Medicare may be a viable option, as the employer-provided plan will likely provide comprehensive coverage.

However, if an individual works for a small employer with fewer than 20 employees, Medicare becomes the primary coverage, and the employer’s plan becomes secondary. In this scenario, it is generally recommended to enroll in Medicare as soon as one becomes eligible.

Individuals should also take into account the coverage benefits and limitations of both Medicare and employer plans. Medicare is divided into different parts: Part A covers hospital stays, Part B covers outpatient services, and Part D covers prescription drugs. While Medicare provides a comprehensive healthcare package, it’s important to carefully examine its coverage to ensure it meets specific health needs.

Employer plans, on the other hand, may have their own limitations and exclusions. It is crucial to thoroughly review the provisions of the employer-provided plan, paying attention to its coverage network, prescription drug coverage, and potential out-of-pocket expenses. Comparing these aspects with Medicare coverage will help individuals make an informed decision.

In addition to considering coverage benefits, individuals should also contemplate the potential penalties of delaying Medicare enrollment. If an individual delays enrolling in Medicare without having employer coverage, they may face late enrollment penalties that can last for the entirety of their Medicare coverage. This can lead to higher premiums and decreased coverage in the long run. Therefore, it is crucial to consider these penalties and evaluate whether it outweighs the benefits of continuing with an employer-provided plan.

See also  The Real Cost of Retirement: Are you Saving Enough?

Ultimately, the decision of whether to delay Medicare or enroll immediately depends on various factors, such as the cost of the employer plan, the size of the employer, coverage benefits and limitations, and the potential penalties of delaying enrollment. It is advisable to consult with a healthcare insurance expert who can analyze these factors and provide personalized advice.

Delaying Medicare enrollment may be a viable option for individuals covered by employer plans that offer comprehensive coverage at a reasonable cost. However, it is essential to revisit this decision annually, as circumstances may change, and one may find themselves in a more advantageous position to enroll in Medicare.

In conclusion, the decision of whether to delay Medicare or enroll immediately is a complex one. Careful evaluation of the employer plan, comparison with Medicare coverage, and consultation with professionals will help individuals make the best decision for their specific circumstances. It is crucial to consider the financial and health implications of delaying enrollment to ensure the best possible coverage and peace of mind during retirement.

Truth about Gold
You May Also Like

43 Comments

  1. MHM Roofing and Construction Inc.

    Thank you Stephanie for the informative videos. I'm turning 65 in May of 2022 I have signed up for Part A but not Part B as I'm planning to work till age 66 and 6 months. I'm currently on an employer health plan and pay less than 170.00 per month. I also am a veteran and I use the VA health care system. Any advice as to whether I'm doing the right thing.

  2. grizz tough

    confusing… I have employer paid HC, I turn 65 this year.. my spouse is 5 years younger, not working. Do I need to sign up for part A or not? Yes, its a large company.

  3. Matt mathew

    Hello. I have some questions about Medicare.

    First of all my birthday is on 09/23/1956 and I work in a big company that has about

    1,541,000 employees and I chose (Aetna HSA, high deductible plan coverage). I want to

    know that is it ok to delay Medicare until I work at this company? Because of injury at

    workplace I am off-work for almost one year and I am under treatment. Does this plan

    works for me?

    The next question is that my wife’s birthday is 05/14/1959 and she will turn to 65 on 05/14/

    2024. She works at a big company with about 2,300,000 employees and has employer

    (KP DHMO Coverage). Is it ok to delay Medicare until she works at this company?

    Please let me know.

    Thank you.

  4. Matt mathew

    Hello. I have some questions about Medicare.

    First of all my birthday is on 09/23/1956 and I work in a big company that has about

    1,541,000 employees and I chose (Aetna HSA, high deductible plan coverage). I want to

    know that is it ok to delay Medicare until I work at this company?

    The next question is that my wife’s birthday is 05/14/1959 and she will turn to 65 on
    05/14/2024. She works at a big company with about 2,300,000 employees and has
    employer (KP DHMO Coverage). Is it ok to delay Medicare until she works at this
    company?
    Please let me know.

    Thank you.

  5. Texas HD Video

    64, took Social Security at 62. On my wife's Large group (>20)plan. This indecisions bugging me, should I stay or should I go?

  6. Cathy Potter

    Stephanie, very well done. I have a question around HSA. Our scenario is my husband turns 65 Sept 2023. I'll be 62 in Aug 2023. My husband wants to start taking his retirement benefit check around 10/1 but we are NOT going to enroll him in Part A & B since as you stated we have an employer rich plan and more than 20 employees, until I retire.. I contribute the maximum to our HSA with a slight employer match to about $8K or whatever the max is for myself and my spouse (no kids). My question is, is it better for my husband to wait until January 1, 2024 to receive his first retirement check since I would have been contributing most of this year into our HSA and not suffer any penalties (or would we incur any penalties at all if we are NOT enrolling him in medicare Part A or B in 2023? If you could please explain all the HSA rules and if it's related to taking Part A and B only or both receiving a retirement check AND being enrolled at least in Part A? I had learned that you can't contribute to an HSA six months prior. However, I'm wondering since I'm 62 this year, can I still contribute the MAX of $8K or just half, as an individual for myself. Sorry for my long questions, all this stuff is difficult to navigate! thanks,

  7. Richard Haynes

    Very informative video. I am 66 wife still working and has about another 8-9 years to go yet. I have been on her employer's health plan she works for a large corporation that has well over 20 employees. I go back and forth on the issue whether I should go onto part B or stay with her plan. Yes complicates process deciding this. Too many working parts in the US health care system.

  8. Ani Cuellar

    What is Saha plan

  9. Steve Ludwig

    I only signed up for Part A at 65 (2020) as my wife's insurance covered me. Can I add Part B and supplement plans before she retires and if so, what is the "window" to do so? Thanks!

  10. Aayan Waris

    Your videos are very useful and provide lots of information. I have received lots of help after watching this post, please continue to share this kind of information. Thank you.

  11. ooscgt

    Thanks so much for the great info. Is the “80/20” rule something to consider too? My employer’s insurance seems to be the way to go for me due to this Medicare rule. Thanks again.

  12. Brian Williams

    This is exactly my predictament, in the next year (4 months before employer new enrollment), (7 months before I reach 65)

  13. Gina Ballard

    If I work past 65 will I be penalized with a delay in the purchase of a supplement plan?

  14. L Alva

    COLORADO?

  15. HDDynaRoy

    I’m turning 65 in 6 months. My wife is 70 and enrolled in part A. We are both collecting SS and I am working as well. My employer health plan costs me $300 biweekly to cover the two of us. It seems like it would be less expensive if we each sign up for part B/advantage plan on my birthday this year. Am I confused?

  16. shay stern

    such an amazingly convoluted game the government makes us play. it should not be like this.

  17. Bill Stenos

    Thank you for your videos
    I will be retiring at the age of 71 to receive my full pension
    I will sign up for medicare part A when I turn 65
    When I retire at 71 I will sign up for Parts B D and G
    Question is will there be any penalties?
    Will I be required to take a physical to be accepted for parts B D G ?
    Will my premimums higher since I am retiring at 71?
    Thank you for your time
    John

  18. -Myal-

    I have been hearing horrific stories about how many Advantage plans have refused to cover their patients' medical issues. However, many Americans cannot afford the cost of Plan B and a supplemental, and a drug plan.

  19. -Myal-

    What is considered a "very high" deductible?

  20. -Myal-

    If a person is allowed to wait 8 months to enroll in Plan B after the employer health sponsored health plan ends, wouldn't that create an insurance gap? If they enrolled right away after losing employer coverage, even using the SEP, would they have to undergo underwriting to get enrolled in a supplemental plan G?

  21. Wayfaring Stranger

    Just shared with family members that recently turned/will turn 65 for an easy to understand breakdown for decision making on whether to delay signing up. You covered all the bases in under 15 minutes- Fantastic! Thanks Stephanie.

  22. Eleri Loki

    My husband is actively employed in a company with more than 20 employees. He will turn 65 in Nov. this year but I won't turn 65 until next July. I'm assuming we should continue his employee health benefits until I am 65 then opt out as it will most likely be cheaper to do so. We also contribute to an HSA. Will he recieve a penalty if he waits? Or can he sign up for Medicare but leave me on the employer benefits plan?

  23. Frank Schwartz

    So my employer says all employees (and spouses) must switch to Medicare at age 65, whether Active or retired. If we want company contribution towards benefits we must use Via Benefits broker hired by company. My wife is 2 years older than me and will have to come off company plan and go on Medicare at age 65. Employer plan cannot be primary or secondary at age 65.

  24. TEACUPS

    Hello. If you delay Part A&B because of employer heathcoverage until age 70 and then enroll in Medicare, will you still qualify to get Supplemental coverage?

  25. Jack Dreddle

    The huge Federal welfare programs, Social Security and Medicare will cost over 2 trillion this year. Seniors are stealing from their children and grandchildren. Both programs should be eliminated. Seniors should pay their own way.

  26. Jefftonio

    Sound is very good!

  27. Phyllis Nunn

    Thanks for your help, especially Heather (via email)! These videos are great. Also, whoever restyled your lighting and camera angle, etc., from the pre-2022 setup, – awesome job!

  28. Zachary Williams

    How would I make sure that I don’t automatically get enrolled in Part A or B. Don’t want it to mess up the HSA and get tax penalties.

  29. Nong Louie

    I can't thank you enough for your channel and the information you provide. May I ask again in light of any changes in Medicare in 2022: To confirm. I am still working and plan to continue to work until my wife and I collect social security at 100% which is 66 years and 6 mths for her and 8 months for me. In fact I may work until nearly 70 years old due to the current market trend. I actively cover health insurance for my spouse through my global company employer. This year my wife turns 65 before I do. In July I plan to enroll her in Medicare Part A ONLY, 3 months prior her turning 65 to avoid penalty AND delay her enrollment into Part B / Medigap / Part D until I retire from my employer and not during my IEP. When ready to retire I will gather evidence of having health insurance coverage via my employer when applying for Part B for us both during the SEP period with forms CMS-40B and CMS-L564. Wheww… Is that right? Many thanks

  30. Stephen Stone

    Thank you for such informative videos. Are you and your team licensed in Arizona? Just curious for future reference.

  31. Wayne Perry

    I will turn 65 in June. I will continue to work until my 67th Birthday. I have an employee HSA , so I want to delay my Medicare A & B. What forms do I need or who do I need to get in contact?

  32. Frank Schwartz

    My employer won’t allow staying on company plan once we reach age 65. At 65 active and retired employees must enroll in Medicare in order to get any employer contribution. Th8s includes spouses. So there are employees and spouses on different plans.

    My employer also charges a $500 penalty (annual) if your spouse (below 65) is on your company plan but could get coverage through their employer.

  33. **

    Hi Stephanie, I retired in 2019, have terrific healthcare coverage for my wife and I which is fully paid for by my employer and I will be 65 in August. I suspect I will automatically be enrolled in Medicare A & B soon. 1) Do you think I should enroll in Part B since my wife and I have lifetime Healthcare Coverage through my company? 2) If they automatically enroll me in Part B and I decide I don't want it, do I just return the Part B card?
    FYI ~ My employer has over 400 employees and my wife is working a few more years
    Thanks

  34. Wilfredo

    Hi Stephanie, we talked last year when I turned 65. I am a teacher on TRS. I will become FRA for SSA this November, but, I still working. Since I am a teacher, and is not feasible to retire in the middle of the year, specially with teacher crisis, am planning to continue on to 2023, and the retire. My question, as you are here in Texas, how does Medicare compare to TRS; because I may just drop from TRS this August, and start on to Medicare starting in Sep 1st… what do you think I should do?

  35. Elisa Valero

    Hello! What if by mistake I got enroll on PART B? Age 65, still working for a few more months, and with an employer that has over 20 workers…. What do I need to do to fix that?

  36. Rodney Sands

    I am 66 and have not signed up for B but they signed me up for A when I started receiving SS. (really messed up my HSA had to withdraw and pay taxes). My question is when I do want to retire losing my health coverage how long will it take to be covered by Medicare and either a gap or advantage plan where there is no loss in coverage?

  37. Rodney Sands

    I am 66 and have not signed up for B but they signed me up for A when I started receiving SS. (really messed up my HSA had to withdraw and pay taxes). My question is when I do want to retire losing my health coverage how long will it take to be covered by Medicare and either a gap or advantage plan where there is no loss in coverage?

  38. Dano Ozark

    Can your office help me decide which company is best for a G plan and drug coverage- I need coverage starting May 1

  39. Don

    I am employed with medical including dental, vision and prescriptions. My wife just turned 65. Does it make sense to have her enrolled in m we medicare part A only?

  40. Bernard Silver

    Re employer coverage vs part D: not eligible for medicare quite yet but I have been looking around. I take an self-injected biologic and have just been put on a weekly dose. All the Part Ds that I see have such drugs as a Tier 5, and thus I have to pay 5% in the catastrophic coverage phase, so the cheapest I found is an annual cost (just for this drug) of around $14,000. On my spouses plan (with coupons from the manufacturer which aren't allowed under medicare) I am paying about $60 a year, quite a difference! In your experience, are all Part Ds going to be somewhat similar, or are their plans with a cheaper top tier.

  41. spitimalamati

    What about coverage for my spouse who is 3 years my junior? I will be 65 this year, and I plan to work (more than 20 employees) at least to my full retirement age, but even then, my spouse will still be 18 months from their 65th birthday anniversary.

  42. M BAKE

    hi thanks for the video's. my employer says i have ro enroll in medicare at age 65. 8000 employee's, PA. i dont know if they pay for anything after that, what has been your findings.
    i probaly will retire at 65 1/2, 66. and sign up for ss at 66 1/2 my official date.
    thank you.

  43. J. Rich

    Explaint direct Contracting. what is a TPA? Are those the same?

U.S. National Debt

The current U.S. national debt:
$35,911,107,598,198

Source

ben stein recessions & depressions

Retirement Age Calculator

  Original Size