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Group Coverage vs. Medicare after Age 65

Navigating the healthcare landscape isn’t easy. It isn’t easy for those under the age of 65 who have the options of private healthcare, the healthcare marketplace, or employer-offered group coverage, and it really isn’t easy for those over the age of 65 who have Medicare programs thrown into the mix. For those over 65 who have coverage through their employers, it’s essential to understand that you still have to make a few Medicare enrollment decisions.

There are two primary parts of Medicare, and often, it can be to your advantage to delay enrollment in one or both of them if you already have insurance coverage.

The two parts of Medicare to be concerned with are:

· Part A: Hospital Insurance, and

· Part B: Medical Insurance.

Most of the time, if you don’t enroll in Part B when you first have the option to, you will be required to pay a late enrollment fee. If you already have coverage with your employer, however, you can delay that enrollment without the penalty (and still have the option to enroll at a later date). A lot of people choose to take advantage of this because Part B has a monthly premium associated with it and the additional coverage that would be offered by Part B isn’t a value when compared to their employer-sponsored plans.

Part A, on the other hand, is a different situation altogether. With Part A, even with other health coverage, it provides significant value. If you have worked for at least ten years and paid your Medicare taxes, Part A has no monthly premium. The issue here is that if your employer-sponsored health coverage happens to be an HSA (High-Deductible Health Savings Account), there is a chance you might not be able to make any additional contributions to that plan after you have enrolled in Medicare.

There is, of course, the option to keep your employer health plan and also enroll in Medicare on top of it. Whether that is a good idea or not depends on your specific situation. You could easily end up overpaying for coverage you don’t even need. Here’s another consideration which may change things: Do you have a spouse or dependents that are relying on your employer-provided healthcare plan? If so, you may want to think twice about switching away from it because they almost certainly aren’t going to be covered anymore if you leave the plan.

Confused yet? Don’t worry, that’s natural. That’s what we are here for. To get help navigating between group coverage, Medicare, and everything in between, contact us at or call us at 952-941-9418 to book your appointment today.

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