Advocate for Employers

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Advocate for Employers

Employees used to rely on health insurance only when they were sick. Today more people depend on our guidance to live healthier lives and make better health choices. For employers, we know it is not always possible to give your employees the health coverage they need for retirement. That is why we have made it easy for business owners like you to provide your valued employees the information they need for planning a healthy retirement.

Employer Strategies for Medicare

For employees turning 65

Plan ahead to learn what steps to take PRIOR to turning 65 and changing insurance from your employer coverage to Medicare.

For employees 65 and older

Learn what you need to do to switch from employer coverage to Medicare if you are older than 65.

Frequently Asked Questions
You can wait to get your Medicare Part B if you are still working and have Employer sponsored “creditable” health coverage. You can apply for Part A when you turn 65, since Part A does not have a premium, and wait until you retire or stop working or until you lose your employer coverage to apply for Part B. You should apply for Part B no later than 3 months before you want to make your Part B effective. Part B will have a monthly premium of $144.60 (base rate). This premium will be higher based on your income.
Yes. When you turn 65, you can apply to get Medicare Part A, and hold off on getting Part B until a later date. When you apply for Part B, you will need to submit a form completed by your employer, proving you had “creditable” coverage from the date you turned 65 until the date you are requesting to make your Part B effective. This form is called CMS-L564E. You can download it HERE.

Yes you can.

  • If you work for an employer with less than 20 employees, then Medicare will be primary and your employer coverage will be secondary and act as supplemental coverage. If the employer coverage includes what is considered to be “creditable” medication coverage, then you don’t have to purchase a separate Medication or Part D plan. If the coverage is NOT “creditable”, then you will have to purchase a stand-alone Part D Plan (PDP) and pay the corresponding monthly PDP premium.
  • If you work for an employer with more than 20 employees, then Medicare will be secondary and will be considered supplemental coverage to the employer coverage; the employer plan coverage will apply first, along with all of its out of pocket costs, i.e. deductibles, co-payments, etc.

If you don’t apply for Medicare Part A and B during your Initial Enrollment Period, which is 3 months before your 65th birthday, the month of your birthday, or 3 months after your birthday month, then you will be penalized by Social Security.

The only way you will NOT be penalized is if you did not apply for Part A and/or Part B because you had creditable employer coverage. If you had it, you will need to supply the CMS-L564E form to provide proof that you had coverage during the entire period past your Initial Enrollment period.

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