The intersection between Medicare & your group health plan
Older workers make up the fastest-growing segment of the workforce; by 2014, it’s estimated 21% of employees will be age 55 and older. In an economy where more seniors are delaying retirement or foregoing it altogether, the need for clarity on navigation of coupling Medicare and employer-based insurance will be paramount.
The Medicare Rights Center, in partnership with AgeOptions, recently released a toolkit designed to help older adults navigate the transition from employer-based health insurance to Medicare, and those who are dually covered. The toolkit aims to clearly explain how Medicare coordinates with different kinds of employer-based health insurance. Here are five key points from the extensive guide to help your employees.
Coordination of benefits
When an employee turns 65, he becomes eligible for Medicare. In 2010, 39.6 million were enrolled in the government-run health care program because of age-eligibility at an average annual benefit of $11,762. Many employees' health insurance coverage may change when they become eligible, which is where a benefits administrator comes in. The sharing of costs can depend on how old the worker is, if they have a disability and the plan size. "We're expecting for this to become a growing issue," says Doug Goggin-Callahan, director of education at Medicare Rights Center. Because of the coupling of insurance coverage, employer-based insurance can sometimes become the secondary insurance, which is why it's so important for employees to know when to enroll — it can decrease claims and avoid future litigation. The first chance to enroll in Medicare comes in the seven-month period surrounding his 65th birthday, or his 25th month of Social Security. Employees also can enroll early for coverage to start the month they become eligible.
