You can be enrolled in both Medicare and an employer plan, but it might not be the best course of action for you. For companies with over 20 employees, the employer plan is typically the primary payer and Medicare is secondary. In this case, you are not required to enroll in Medicare when first eligible if you remain covered under the employer plan. When you leave the employer coverage, you’ll qualify for a Special Enrollment Period.

For companies under 20 employees, Medicare is the primary payer and the employer plan is secondary. In this case, you should sign up for Medicare when first eligible to avoid penalties later. Keep in mind that while you may be eligible for premium-free Part A (Hospital Insurance), you will have to pay a premium to have Medicare Part B.

Yes, as long as your employer has more than 20 employees and you are enrolled on the group health plan. Many people who are still working, and covered under an employer plan with more than 20 employees, enroll in Part A but postpone enrolling in Part B. This is because Part B charges a monthly premium and often duplicates the employer plan coverage. If you are enrolled in Medicare and an employer plan, Medicare will coordinate benefits. If the company you work for has more than 20 employees, Medicare will pay out as a secondary payer and the company plan pays out as primary payer. It’s important to note that if you enroll in Medicare (Part A or Part A & B), you can no longer contribute to a health savings account (HSA).

If you are enrolled in Medicare Part A, you may no longer contribute into a health savings account (HSA). Your employer can no longer contribute to an HSA on your behalf either. If you are enrolled in an HSA compatible health plan through your employer and wish to keep contributing pretax dollars into your HSA, you should consider postponing enrollment into Part A.

It really depends on your specific situation. If you or your spouse are considering leaving your employer coverage and enrolling in Medicare, you’ll want to consider things like:

• How the premium costs compare. Consider what you pay in premium each month for your employer plan and what the Medicare package will cost.
• How your coverage and out-of-pocket costs compare. Consider how the employer plan benefits compare to the Medicare plan benefits as well as your out-of-pocket costs like deductibles, coinsurance, copays and annual maximums.

Medicare Part A & B leaves some gaps in coverage and cost-sharing which is why many people add on a Medicare insurance plan. Medicare insurance plans are offered by private insurance companies, not Medicare.

There are two different types of Medicare Health Insurance plans, and you pick one or the other:

1. Medicare Advantage plans (also known as Part C or MA). Note that these typically include Part D prescription drug coverage.
2. Medicare Supplement plans (also known as Medigap). Note that these plans do not include prescription drug coverage so to have that, you would need to enroll in a stand-alone Part D prescription drug plan.

* You will continue to pay your Medicare Part B premium in addition to the premiums for the plan you select.