If you are currently insured by your employer, getting Medicare coverage may be a bit more complex. People who will soon be eligible for Medicare coverage, but already have another form of coverage, may desire to enroll in Medicare anyway. Before doing so, you should understand how Medicare will affect your existing benefits.
How Does Medicare Work With Other Insurance?
When you have Medicare and other health care coverage, each instance of coverage is referred to as a “payer.” When you have more than one payer, the coordination of benefits you choose will decide which policy pays for approved services first. The primary payer is first to pay, and the secondary payer pays the remainder in most cases. Though, sometimes people also have a third payer.
Will Medicare Pay First If I Have Other Insurance?
Which company is the primary payer will depend on the specific nature of your policies, but in general, if an employer has 20 or more employees, the group health plan offered through your employer will pay first. Medicare will make the secondary payment based on what the group plan paid out. If neither plan covers a charge, you will be responsible for paying it.
If your employer has fewer than 20 employees, Medicare will likely be the primary payer and pay first. In some cases, employers will work with other employers to create a multi-employer plan. If any of the organizations involved in a multi-employer plan has more than 20 employees, Medicare becomes the secondary payer.
In instances where your domestic partner has group health insurance that covers you, Medicare will pay first if your domestic partner is entitled to Medicare based on their age or if their domestic partner’s group health plan benefits are covering them.
These are only some examples of how Medicare will interact with other insurance policies. To know specifically how your insurance will hold up with Medicare and which payer will be primary or secondary, you should seek assistance from an insurance professional.
Penalties For Enrolling With Employer Coverage
If you have employer insurance coverage, you may be considering waiting to enroll in Medicare. In some cases, you may be able to delay enrolling in Part A and Part B of Medicare without incurring late enrollment penalties. In many cases, the size of your employer will determine whether you have to pay any penalties for late enrollment.
Find Coverage
If you are unsure about when or how you should enroll in a Medicare policy, you should speak to an insurance agent. The professionals at Cornerstone Senior Advisors will advise you on how your employer’s group health plan will work with Medicare and guide you towards the best solution. Contact us now for a free quote.