Do I Need Medicare Part B if I Have Employer Insurance? – Zupnick Associates

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By Stephen Weru

“Do I need Medicare part B if I continue working past 65 years and still have a group health plan from my employer?” This is a common question among many employees who continue working past their retirement age.

If you’ve been asking this question, this article is for you. In this post, we provide a comprehensive answer to whether you should sign up for Medicare part B if you still have employer insurance. Therefore, we’ll guide you to make the best choice regarding your coverage.

Let’s get right into it.

What is Medicare Part B?

Medicare is a government-sponsored health insurance plan meant for Americans aged 65 years and above. People with certain disabilities and those diagnosed with ALS or end-stage renal disease are also eligible for Medicare.

When you enroll for Medicare, you can get coverage through the Medicare original or Medicare Advantage.

Coverage from Medicare original includes Medicare Part A and Medicare Part B. Medicare Part A covers all your hospital bills including:

  • Inpatient care

  • Home health care

  • Nursing home care

  • Hospice care

Medicare Part B on the other hand covers all your medical bills including:

  • Ambulance services

  • Inpatient and outpatient mental health care

  • Surgery

  • Medical equipment

  • Chemotherapy

  • Dialysis, among other medical procedures.

When deciding whether to choose Part A or Part B, it’s important to note that Medicare Part B is responsible for paying 80% of your hospital bills if Medicare is your primary insurer.

Should I Sign-up for Medicare Part B if I Have Employer Insurance?

The answer to this question depends on your employer.

If you work in a company with less than 20 employees and are eligible for Medicare, you must sign up for Medicare. If you don’t sign up for Medicare, you’ll face a late enrollment penalty when you decide to register.

If you work for an organization with more than 20 employees, you don’t have to sign up for Medicare. Under such a circumstance, you won’t face the late enrollment penalty when you finally decide to sign up for Medicare.

Even if you’re not 65 years old but are eligible for Medicare due to disability, you can delay registering for Medicare Part B until you get to 65 years. However, you need to be receiving group health coverage from an organization with more than 20 employees.

If you’re looking to save on the Part B premiums (which will be $148.50 in 2021), you can choose to delay enrollment for part B, as long as you still receive coverage from  your employer’s group health insurance plan.

Medicare Part B and Employer Insurance

You can also choose to have both Medicare Part B and your work health insurance. For such situations, both coverages work in conjunction with one another.

However, depending on your employer, Medicare can either be your primary or secondary payer.

If you work in a company with less than 20 employees, Medicare becomes your primary insurance company. Based on this arrangement, Medicare Part B will pay most of your bills; then, your employer insurance pays for part or all of the remaining costs.

If you work in a company with more than 20 employees, Medicare becomes your secondary insurance. Your group health insurance covers most of the medical bills, while Medicare pays for the remaining portion.

Registering for Medicare Part B on a Delayed Basis

You may choose to delay enrollment to the Medicare Part B coverage if your employer-funded insurance policy still covers you.

However, what happens when you retire and lose employer coverage?

For such scenarios, Medicare gives you an 8-month special enrollment period where you can register for Part B without the risk of penalties. However, if you wait for more than a year after you retire to register for Medicare Part B, you’ll be charged a lifetime penalty of 10% on your Part B monthly premiums.

Insurance experts recommend that you set up Part B to start the day after your employer-sponsored health insurance ends.

Conclusion

The answer to the question on whether you need Medicare Part B is up to you.

We hope that this article was helpful in helping you decide on the best approach to take regarding registering for Medicare Part B.

If you have any questions regarding Medicare Part B, leave it in the comment section. We’ll do our best to answer any question asked.

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