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If you’re one of the many Americans planning to work past the traditional retirement age of 65—or are already doing so—you may face a decision about whether to rely on Medicare for your healthcare or stick with insurance coverage through your employer.
In his new column for Considerable, Phil Moeller, the author of Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs and the co-author of the updated edition of The New York Times bestseller How to Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security, answers three reader questions about coordinating company insurance with the federal program.
What comes first: Medicare vs. insurance at work?
Meda-Kay, Louisiana: If I have Medicare Parts A and B through a Medicare Advantage plan and a commercial policy through work. Which policy is primary?
Phil Moeller: If your employer has more than 20 employees, its plan normally continues as the primary insurance when an active employee turns 65.
In this case, you should look at the benefits you get from having Medicare as secondary coverage and decide if they’re worth what you are paying.
If you do decide to drop Medicare, you can re-enroll at a later date with no problems or penalties. Medicare usually is the primary insurance in smaller employer plans.
Can my boss keep me from dumping my company coverage?
Elizabeth, W.Va.: I am still working and will turn 65 in October. I have health insurance through my employer. The cost to me is reasonable, about $100 a month, but comes with an annual deductible of $1,000, which I never meet!
I know that to sign up for Part A and Part B would cost me only $34 more dollars a month and lower my deductible dramatically. Also, I would likely do a Medicare Advantage plan to get some dental and vision coverage, which I now lack.
I don’t currently take any prescription meds. It seems to me that Medicare is the way to go.
My employer’s initial response when I broached the subject was that he “would not allow” me to waive the company insurance. The insurance is not part of a union contract and the employer doesn’t pay 100% of my premium, so it seems to me that waiving it is my right. Thoughts?
Phil Moeller: I am not an expert on the many, many versions of private employer health policies. I have heard that some employers stipulate that employment is conditioned on accepting employer insurance as mandatory.
If that’s the case, you should have been informed as part of the hiring process and, of course, the employer should be able to provide you this policy in writing.
I can’t really advise you on how hard you should push. Do you think doing so would cause long-term damage in your relationship with your employer? If so, how big a problem might that be?
Also, I’d advise you to get at least a low-cost Part D Medicare prescription drug plan wrapped into your Medicare Advantage plan. At some point, you will need such coverage and Medicare then would hit you with permanent late-enrollment penalties.
Would retiree health benefits beat out Medicare?
Charlene, Arkansas: I have federal health care and work for the post office. I plan to retire at age 66 and wonder if it would be better for me to just to keep my employee health insurance only and not take Medicare part B or have both after retirement?
Phil Moeller: I can’t answer your question because I don’t know your current health needs and certainly can’t predict what your future health costs will be.
Generally, getting Part B will improve the completeness of your health coverage. The question is, of course, how much coverage you might need and whether this benefit is worth the $164.90 ($174.70 in 2024) a month that most folks now pay for Part B.
It can take some time, but one way to proceed here is to take some possible health events—cancer, for example, or joint replacement surgery, or an extended stay in a nursing home or hospital.
Find out how your retiree coverage would work and how much having Part B would help. This is not easy to do, but it would help you make an informed decision about Part B.
These questions previously appeared on the PBS NewsHour Making Sen$e website.
