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Life Health > Health Insurance > Medicare Planning

Switching From Employer Coverage to Medicare Now: Medicare Customer Questions

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(Related: The COVID Shot: A Medicare Customer Question)

Some Medicare questions are connected to financial and health concerns brought on by the pandemic.

If your client is over the age of 65 and using employer-sponsored health coverage, here are a few questions your client might want answered before making the switch to Medicare.

Should I be thinking about Medicare right now?

During the pandemic, Medicare beneficiaries have the added benefit of temporary telehealth coverage, meaning now is a good time for all those eligible to make the switch. COVID-19 tests and antibody/serology tests are also covered by Medicare Part B, with no out-of-pocket costs, and any future coronavirus vaccine will also be covered.

Most individuals who switch to Medicare do so to take advantage of the savings, with Medicare premiums starting at $144 and deductibles at $198. Medicare coverage options also give beneficiaries access to 93% of primary care doctors nationwide.

For those on employer plans, the benefits of switching to Medicare are clear. The majority of employers (81%) offer only one plan and 71% of workers under employer plans are charged a copay for visits to primary care centers. By comparison, out-of-pocket costs can be heavily reduced or cost-free for those with Medicare coverage.

When do I have to decide?

Medicare’s annual open enrollment period is right around the corner. From Oct. 15 through Dec. 7, all those with Original Medicare, Medicare Advantage or Part D prescription drug coverage can switch plans. There is an additional opportunity for individuals enrolled in Medicare Advantage or prescription drug plans to switch to a 5-star rated Medicare Advantage plan or return to Original Medicare between Dec. 8 and Nov. 30.

Also, if you are approaching or already age 65 and still working, most employers offer a life event to transfer from your employer coverage at any time throughout the year if you enroll in Medicare Part B. This means you may be able to look at your Medicare options at any time.

Where can I turn if I have more questions?

You can start by speaking with your human resources department, since they may have resources for your decision to switch to Medicare. Additional resources include or state health insurance assistance programs (SHIPs), both of which are government-supported.

Individuals can also find Medicare plan selection services that can help you make comparisons between your employer and Medicare options in order to determine which plan best fits your needs.

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Bethany CissellBethany Cissell is a health care insurance services specialist at Allsup.


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© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.