Medicare or My Employer's Health Plan Better Option?

If your working spouse has excellent employer health insurance, you may wonder whether a disabled spouse should switch to Medicare at age 65 or stick with the employer plan.

Understanding what Medicare covers is the first step. Medicare Part A helps pay for hospital and facility costs. Part B helps pay for medical costs. Part D covers prescription drugs. Part A typically has no monthly premium, while Parts B and D involve costs.

Individuals who have received disability benefits from Social Security for 24 months automatically qualify for Medicare Parts A and B at eligibility. However, Part B enrollment can be delayed by contacting Social Security.

The standard 2021 Part B premium is $148.50 per month, if your income was $176,000 or less in 2019 for a married filing joint return. The premium increases based on higher income levels.

It is recommended that you enroll in supplemental Medigap coverage within six months following Medicare Part B enrollment to cover remaining costs like copayments and deductibles.

The key recommendation is to compare total Medicare expenses, including Part B, Part D and potential Medigap costs, against your current employer plan before deciding which option provides better value for your specific situation.

Contact our office today to schedule a consultation.