Why People Switch To Medicare From Their Employer’s Group Health Plan

By Bethany Cissell

Your employer’s benefits open enrollment season is an ideal time to consider enrolling in Medicare if you are eligible – meaning you are turning 65 in three months or less, or have been working past age 65. You might be surprised to find that Medicare offers extensive coverage at an affordable rate when compared to other health insurance.

Savings

One of the main reasons people choose Medicare over their employer’s group health plan is cost. Employer health plans often become more expensive as people age. Premiums, deductibles and out-of-pocket costs can add up, making it less financially feasible to stay on a group plan. Medicare’s premiums tend to be more stable.

Medicare can be more affordable, especially when considering the different parts of Medicare. Medicare Part A (hospital insurance) is typically premium-free for most people who have paid FICA taxes while they worked. Part B (medical insurance) comes with a standard premium, which can often be less than what you’re currently paying on your employer’s group health plan. Additionally, Medicare Advantage plans (Part C) and prescription drug plans (Part D) offer a range of coverage options that can be personalized to your needs and budget, potentially saving you more money toward retirement.

Comprehensive Coverage

Medicare offers comprehensive coverage that can sometimes be more extensive than what’s available through an employer’s group health plan. For example, Medicare covers a wide array of medical services, including hospital stays, outpatient services, preventive services and even prescription drugs. Medicare Advantage plans often include additional benefits such as dental, vision and hearing coverage which may not be included in a traditional employer plan.

Medicare plans offer options for coverage. Medigap supplement plans offer the ability to see any doctor as long as they accept Medicare. They are higher premium plans with little out-of-pocket expense. Medicare Advantage plans have a network of providers but offer low premium plans and copays and coinsurance as you use the plan.

Medicare 2025 Prescription Drug Coverage Cap

Next year, Medicare has a $2,000 cap for out-of-pocket drug costs. With the ever-increasing cost of medicine, this could make Medicare a very attractive option for those with high prescriptions costs or individuals who have been prescribed multiple pharmaceuticals.

Switching to Medicare from an employer’s group health plan is a complicated decision made less so by factors like cost, coverage and the new prescription drug coverage cap. You may find that Medicare offers more affordable, comprehensive options that align with your lifestyle – whether you are retiring or continuing to work. Knowing your Medicare options helps you make an informed decision about leaving your employer’s plan. You can also sit down with an experienced healthcare benefits expert like Allsup to walk you through a comparison of your employer’s benefits and what’s available to you via Medicare.

About Bethany Cissell

Bethany Cissell has written 1 posts in this blog.

Bethany Cissell is director of business development and a Medicare expert at Allsup, a nationwide provider of Social Security disability, veterans disability appeal, disability financial solutions and healthcare benefits services for individuals, their employers and insurance carriers. Allsup professionals deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible.