Can I Have Medicare and Employer Coverage at the Same Time?

Can You Have Both at Once?

Yes, in many cases you can have both. If you or your spouse are still working and covered by an employer group health plan, that coverage can work alongside Medicare. Which one pays first depends on the size of the employer and the type of coverage.

How Coordination of Benefits Works

• If the employer has 20 or more employees, the group health plan generally pays first and Medicare pays second.

• If the employer has fewer than 20 employees, Medicare generally pays first and the group plan pays second.

• You can typically delay Medicare Part B enrollment without penalty while covered by a qualifying large-employer plan.

Frequently Asked Questions

Do I have to enroll in Medicare if I have employer coverage?

Not necessarily. If your employer plan qualifies as creditable coverage and the company has 20 or more employees, you can typically delay Medicare enrollment without a late penalty until that coverage ends.

What happens if I miss my Medicare enrollment window?

If you don’t have qualifying employer coverage and miss your Initial Enrollment Period, you may face a lifetime late-enrollment penalty and have to wait for the next General Enrollment Period to sign up.

Should I still sign up for Medicare Part A if I have employer coverage?

Many people enroll in premium-free Part A as soon as they’re eligible, since it usually costs nothing and can help cover hospital costs. Check with your employer plan first if you have a Health Savings Account, since Part A enrollment can affect HSA contributions.

What is a Special Enrollment Period for employer coverage?

It’s an 8-month window that starts when your employer coverage ends or you stop working, whichever comes first. It lets you enroll in Medicare without a late penalty, even outside the standard enrollment periods.

Does COBRA count as creditable coverage for Medicare purposes?

No. COBRA is not considered creditable employer coverage for delaying Medicare enrollment, even though it continues your group health benefits after you leave a job. If you rely on COBRA past your Initial Enrollment Period, you could face a late-enrollment penalty, so it’s important to enroll in Medicare on time regardless of COBRA.

Call Us Today to see if Medicare and employer coverage fits your situation. Call 1-800-432-9757 or schedule a free consultation.