Medicare Insurance Agent
Long Beach California

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Can Medicare be Secondary to my Employers Insurance

This is a common question medicare beneficiaries have when covered by an employer plan and Medicare. If you are still working and your are current covered by an employers plan we get asked: Can Medicare be Secondary to my Employers Insurance or will it be primary.  

This question comes up as these individuals may have great coverage offered by their employer but they are seeking to fill in some additional gaps.  

How those gaps are filled is related to how large or small your employer is.  If you or your spouse work for a company that has less than 20 employees then Medicare would pay first and your employers plan would be considered secondary.  

If your employer has 20 or more employees then, the employers plan would pay first and Medicare would be considered secondary.  

After both insurance companies have paid any remaining balance would be sent to you to cover.

It will be important for you to remember, that once your employers plan ends you will need to reach out to the Social Security Office.  As you are now only covered by Medicare and it will be important for them to be made aware of this change.  If you forget to call Social Security Office, they may still have your billing set-up incorrectly and this can cause you some grief.

Do I need to keep my employers plan if I want to move to Medicare only?

I would first recommend talking with your employer before making any decision about canceling your employers group coverage.  

Your employers coverage may include thing that may not be included under Medicare.  Some things that may not be included that you could be responsible for are the following:

  • Most Dental Coverage
  • Chiropractic Care
  • Acupuncture
  • Hearing Aids
  • Long Term Care
  • Eye exams related to prescribing glasses

Depending on your current and/or future medical needs, you may find these medical coverages important to keep through an employers plan.  While you can purchase comprehensive dental coverage, depending on how much your employers monthly premium is it may or may not be worth dropping.  This is something we would want to consider before making any decisions.  

When looking at the original question of can Medicare be secondary insurance, I always like to examine what you have in place first and how much you are paying verses what your employer is paying before we simply cancel your employers plan.  

It would always be better to keep your current plan and double up by adding Medicare verses not being able to re-join your employers plan after the fact.  

Remember that group health insurance has an open enrollment period. If you cancel your group health insurance you may not be able to re-sign back up for many months later.

I am a Veteran do I need Part B Coverage?

As a Disabled Veteran myself I receive my medical care through the VA Hospital in Long Beach California.  I am fortunate to live only 10 minutes away. 

Even though I have close access to the VA Hospital, once I am eligible for Medicare I will be required to sign up for Part B coverage.  This is because the VA Hospital is not deemed to be creditable coverage.

By signing up for both Part A and Part B this will allow you the flexibility to obtain a second opinion or if you are not close to a VA facility to see a Doctor that is local to you.

That being said, the VA Hospital does qualify for creditable coverage for your prescription drug coverage.  This means you will not be required to sign up for Part D coverage.

Can Medicare be Secondary - US Veteran

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