Aging Options

Medicare Eligible but Still Employed? Here Are Some Things You Need to Know About Your Choices

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Medicare Open Enrollment for 2019 is underway. Americans 65 and older have until December 7th to either enroll in Medicare or to switch from one plan to another. But what if you’re Medicare-eligible and still employed full-time, receiving health care benefits through your employer? Does Medicare affect you?

The answer is yes – but like everything else related to Medicare, it can get complicated.

Employer Plans and Medicare Need to Work Together

We recently found this very helpful article on the website of the highly popular PBS Newshour. Written by journalist Philip Moeller, the title immediately caught our eye: “Working after 65? What you need to know about employer insurance and Medicare.” Even if you don’t plan to enroll in Medicare right now but intend to keep your company health insurance, this article is full of helpful insights, not just for you but for other seniors you know.  “With so many people continuing to work once they turn 65, the interaction of employer insurance and Medicare is important but often confusing,” Moeller writes. He says he gets more reader questions about the interplay between government plans and employer plans than any other single topic, with the top queries boiling down to these four:

  • “My employer tells me it will force me to get Medicare. Can they do that?”
  • “I don’t plan to stop working, and I like my employer health insurance. Do I need to get Medicare?”
  • “I don’t plan to stop working, and I hate my employer health insurance. Can I get Medicare?”
  • “My employer says they’ll help pay for my Medicare if I will drop my employer insurance. What’s allowed?”

We’re not going to attempt detailed answers to these questions here on the AgingOptions blog – we suggest you read the PBS article and click on the various links for that – but we will try to hit the high points. We encourage you to bring your Medicare-related questions to one of our AgingOptions LifePlanning Seminars because it’s entirely likely that others have the same questions you have, and seminar host Rajiv Nagaich will almost surely have the answers for you. We’ll tell you more about the upcoming LifePlanning Seminars in a moment.

Large Employers Can’t Force You into Medicare

One of the first things you need to know, Moeller writes, is that Medicare has different rules for large employers than for small ones (generally companies with 20 employees or fewer). If you work for a big company with health insurance, you do not have to get Medicare, but you can if you want, says the article. “If you work at a large employer plan, your employer cannot treat you differently than younger employees. You and, if applicable, your spouse, must continue to be offered employer health insurance. These rules are very clear. If an employer with a large health plan tells you that you must get Medicare at age 65, it is breaking the law.” If you decide on your own to switch your coverage from the company plan to Medicare, you’ll need to check with your company’s HR department or other benefits coordinator to find out whether dropping your employer-provided coverage carries any adverse consequences.

The picture is different for small-company plans. “If you work at a small employer plan, your employer is permitted to require you to get Medicare when you turn 65,” says PBS. “At that time, Medicare will become your primary health insurer.” Small employers generally have the right to cancel your coverage once you become Medicare-eligible.

Large Employers Can’t “Bribe” You into Medicare

Reporter Moeller said in the Newshour article that he is often asked whether an employer can offer financial incentive or other monetary assistance to induce older employees to drop the company coverage and enroll in Medicare. If you work for a large employer, “the answer is an unequivocal ‘no.’”   He writes, “If you work at a place with a large employer health plan, it is illegal for your employer to offer you any inducement to get Medicare and drop the employer’s plan. Based on my mailbag, such illegal offers are not uncommon. While you may find the offer attractive, just keep in mind that it’s not allowed.”   However, the rules governing small employers are not so clear: again, we direct you to the article (and this hard-to-understand 7-page IRS “explanation”) for further details. This is one area where expert advice is essential.

Get Some Solid, Reliable Advice!

Expert advice concerning everything related to retirement is our specialty here at AgingOptions. We not only have highly-trained and experienced subject-matter experts working as part of our AgingOptions team, but we also utilize a network of like-minded professionals to advise you on everything from detailed financial planning to reverse mortgages to long-term care insurance to care coordination for families. We can serve as your “trail guide” on the journey to a safe, secure, rewarding retirement, no matter what your circumstances. What sets us apart from other so-called retirement planners is our holistic focus, blending together the critical elements that make up a successful plan: medical, housing, financial, legal and family. Once you experience the power of a LifePlan from AgingOptions, you’ll realize it’s the only type of retirement plan that can help you fulfill your dreams for the future.

Rajiv Nagaich of AgingOptions invites you to join him at one of our highly popular LifePlanning Seminars, offered absolutely free at locations throughout the region. You’ll find a complete calendar of currently scheduled seminars here on our Live Events page, where you can register for the seminar of your choice. Of course, feel free to call our office if we can assist you or answer any questions. Don’t let confusion or fear about the future paralyze you into indecision. Take action today and you can secure a brighter tomorrow, thanks to AgingOptions. Age on!

(originally reported at

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