Even without living through a worldwide pandemic, a growing older workforce may be leading to higher company health care costs because of higher rates of chronic illness and health care needs.
Increasing costs for individuals can ripple to employers and all employees through the companywide benefits program. Because many businesses have had to shut down entirely this year, losing months of profits, it may be important to explore alternatives for health care cost savings and improved benefits for workers.
One solution to save on costs while supporting an evolving workforce is helping eligible older workers make the switch to Medicare. Many individuals working past age 65 who compare Medicare to their employer coverage may be able to get improved health care coverage and lower costs.
Here are answers to four questions clients who have worked past age 65 may have about the idea of making the switch.
1. Who is eligible for Medicare?
To be eligible for Medicare, a client who is not facing end-stage kidney disease must be a U.S. citizen or have been a legal resident for at least five years. An older worker must be age 65 or older and have worked for at least 10 years in Medicare-covered employment.
2. Why should people take a look at Medicare if they have employer coverage?
There can be some important advantages from comparing a client’s employer plan with Medicare.
For example, 81% of employers offer only one health plan option. That means, if the plan does not cover a client’s preferred doctor or the specific procedures and services the client needs, the client will be out of luck
On the other hand, Medicare covers 93% of primary care doctors nationwide, allowing older individuals to choose the doctors they prefer. There also can be important provisions in Medicare that aren’t offered by employer coverage.
3. How much can qualified workers save on Medicare vs. an employer plan?
They may be able to save significantly on their premiums, copays and cost-sharing, depending on their employer plan. Medicare premiums start at $144, and Medicare deductibles start at $198 or may be much less for those who choose Medicare Advantage.
In addition, 71% of workers with employer plans are charged copays or cost-sharing for visits to primary care centers, while Medicare has alternatives that greatly reduce out-of-pocket costs.
4. Does Medicare offer COVID-19 coverage?
Yes, Medicare beneficiaries have access to temporary coverage for telehealth for the duration of the pandemic.
They also are covered for COVID-19 tests and antibody/serology tests, with no out-of-pocket costs under Medicare Part B. In addition, once a vaccine is available, it will be completely covered by Medicare.
Bethany Cissell is a health care insurance services specialist at Allsup.