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How do your employees transition to Medicare from Employer-based health insurance?


These days there are a lot of people working past 65, the age when you become eligible for Medicare benefits. As a result, many of them are postponing their Medicare enrollment under the qualifying condition of having “creditable coverage.” This allows them to skip enrolling in Medicare Part B while they continue to have creditable coverage from current employment. If the coverage is creditable, they can do so without penalty, until they lose their employer coverage. If they postponed Medicare Part B enrollment and are now losing your creditable employer coverage due to retirement or job loss, they need to consider a few things. We put together a breakdown of how to transition to Medicare.

Enrolling in Medicare

Their first order of business is to enroll in Medicare. This normally needs to be done during their Initial Enrollment Period when they turn 65. If they continued working past 65 and maintained creditable coverage, then they are allowed a Special Election Period. The Special Election Period will allow them to enroll in Medicare, as well as choose a Medicare Advantage Plan or Medicare Supplement. Many beneficiaries approach Human Resources on Medicare questions, so here is a quick overview so you can feel comfortable with the basics.

How long do they have to enroll in Medicare?

Once they lose employer-based coverage, they have a special enrollment period for 8 months to enroll in Part B. It is very important to note that COBRA coverage is not considered “creditable coverage” by Medicare. They will need to enroll in Part B within 8 months of the date that they cease to have coverage from current employment to avoid a penalty. Once Part A and B are in place, they will have what is referred to as “Original Medicare”. If they want to add a Medicare Advantage Plan or a Medicare Supplement Policy, then below outlines the Special Election Period for those plans.

Special Election Period for Medicare Advantage/ Medicare Supplements

If they are looking to add a Medicare Advantage Plan (MA/MAPD) or a Medicare Supplement Plan to fill the gaps of Original Medicare, there are separate Special Enrollment periods as outlined below.

  1. If you already have Part B before losing creditable coverage, or you enroll in it as soon as you lose your coverage then you have 63 days after the loss of employer coverage to enroll into a Medicare Advantage plan.
  2. If you don’t take Part B right away but add it within the 8 month Part B window then you would need to pick your Medicare Advantage Plan the month before your Part B becomes effective.
  3. If you want to buy a Medicare Supplement plan, you will have a guaranteed issue period to buy one with no health questions asked, for 6 months after you first get Medicare Part B.

When to speak with a Licensed Agent?

Medicare is confusing and we don’t expect Human Resources to learn all of the ins and outs! This is where The Medicare Navigators comes in. If your employees are confused about when and how to enroll to avoid penalties, ensure continuous coverage, or want to learn the difference between Medicare Part A, B, C, and D, then we can answer those questions for you. The best time to speak with us is 6 months before they lose creditable coverage if they have advanced notice, or as soon as they find out they will or have lost coverage.

Our agents are Licensed, Trained and Certified to help you and your employees navigate Medicare.