Turning 65 doesn't always mean you need to retire or enroll in every part of Medicare. If you or your spouse are still working and covered by an employer health plan, your Medicare decisions depend on your specific situation.

One of the first questions we ask is:

"Are you currently covered by an employer health plan?"

Your answer helps determine when you should enroll in Medicare and whether keeping your employer coverage is the best financial choice.

Questions We Help Answer

Many people ask us:

• Should I keep my employer health insurance?
• Do I need Medicare if I'm still working?
• Should I enroll in Part A only?
• Should I delay Part B?
• Would Medicare cost less than my employer plan?
• When should I switch from employer coverage to Medicare?

There isn't a one-size-fits-all answer. The right choice depends on your health coverage, employer benefits, and future retirement plans.

Factors We Consider

Before making a recommendation, we review:

• The size of your employer.
• Your monthly payroll deductions for health insurance.
• Your deductible and out-of-pocket costs.
• Whether your employer coverage is considered creditable.
• Whether your spouse is covered under the same plan.
• Whether you contribute to a Health Savings Account (HSA).
• Your expected retirement date.

Should You Enroll in Medicare Part A?

Many people choose to enroll in Medicare Part A because most individuals qualify for premium-free Part A after earning enough work credits.

Since Part A primarily covers inpatient hospital care, it may work alongside your employer coverage in certain situations.

However, if you actively contribute to a Health Savings Account (HSA), enrolling in any part of Medicare, including Part A, generally affects your ability to continue making HSA contributions. If you plan to keep contributing to your HSA, speak with your tax advisor before enrolling.

Should You Delay Medicare Part B?

Unlike Part A, Medicare Part B requires a monthly premium.

If you're covered under a creditable employer health plan, many people choose to delay Part B while they continue working. Since their employer plan already covers outpatient medical services, paying an additional monthly Part B premium may not always make financial sense.

The decision often depends on:

• Your employer plan deductible.
• Your expected medical expenses.
• Your monthly premium costs.
• The benefits offered through your employer.

If your employer plan has a high deductible and you frequently receive outpatient care, enrolling in Part B may reduce your overall healthcare costs. If your employer coverage already provides strong benefits with reasonable costs, delaying Part B may be the better option.

Will I Pay a Late Enrollment Penalty?

If your employer coverage qualifies as creditable coverage, you may delay Medicare Part B without paying a late enrollment penalty.

When you retire or lose employer coverage, you'll typically qualify for a Special Enrollment Period to enroll in Medicare.

Keep any documentation from your employer confirming your creditable coverage. You may need this when enrolling in Medicare later.

Employer Size Matters

One of the most important factors is how many employees your company has.

Employers with Fewer Than 20 Employees

In many cases, Medicare becomes the primary payer once you turn 65.

This often means you'll need to enroll in both Medicare Part A and Part B to avoid unexpected medical expenses.

Employers with 20 or More Employees

For larger employers, your group health plan generally remains your primary coverage while you're actively employed.

Many people in this situation choose to delay Medicare Part B if they're satisfied with their employer benefits and costs.

Every employer plan is different, so reviewing your benefits before making a decision is important.

Health Savings Account (HSA)

If you're enrolled in a qualified High Deductible Health Plan and actively contribute to an HSA, Medicare rules require special attention.

Once any part of Medicare becomes effective, you generally cannot continue making HSA contributions.

Before enrolling, consult your tax advisor or benefits administrator to understand how Medicare could affect your HSA eligibility.

What If I Have Retiree Coverage?

Some employers offer retiree health benefits after employment ends.

If you receive retiree coverage, Medicare generally becomes your primary insurance.

Depending on the cost and benefits of your retiree plan, you may find that Original Medicare combined with a Medicare Supplement and a Part D prescription drug plan better fits your healthcare needs and budget.

Let Us Help You Compare Your Options

Choosing between employer coverage and Medicare involves more than comparing monthly premiums.

We'll help you evaluate:

• Monthly costs
• Deductibles
• Copayments
• Prescription drug coverage
• Provider access
• Medicare enrollment deadlines
• Long-term healthcare costs

I will explain your options and help you decide whether keeping your employer coverage or enrolling in Medicare makes the most financial sense for your situation.