Group vs Medicare -WealthArchitect
Approaching Medicare Eligibility?
- You are continuing to work.
- Your current costs are less than if you switch to Medicare.
- You don’t need a personalized plan ensuring your provider is in network.
- You are retiring.
- You are employed by a small business with less than 20 employees.
- You want or need specific providers not covered under your Group Health Plan.
Years in Medicare
Insurance plans offered
Do you work for a small company?
If your employer has less than 20 employees, you may want to enroll in Medicare Parts A and B, since most small group plans pay as though you have Medicare. Medicare is primary and your Group Health plan is secondary. [Contact your HR department to confirm before you decline Medicare]
Do you work for a large company?
Your Group Health Plan is primary and normally will enroll in no-cost Medicare Part A only. If you pay the full premium for your Medicare-eligible spouse you may want to consider Medicare and Supplemental coverage. The Medicare route could lead to significant savings on premiums and better benefits.
Is your Group Health Plan an HSA?
If your Group Health Plan is an HSA (funded by you or employer) you will not want to enroll in Medicare Part A or Part B since you cannot contribute to an HSA if enrolled in any part of Medicare. Make sure you have not claimed any Social Security benefits or you could be billed back. If you have, call one of our advisors today.
Is Your Group Health Plan Creditable?
It’s important to ask your HR department if your Group Health plan includes creditable Prescription Drug Coverage (meaning the coverage is expected to pay on average as much as the standard Medicare prescription). If your Group Health plan is not creditable coverage, you will want to enroll in a Part D plan to avoid penalty. Most plans are creditable coverage.