Turning 65 years old is often a huge relief for most because Medicare offers a much less expensive alternative to traditional health insurance options. However, if you are currently working and receive benefits from your employer it may make this a more difficult decision.

Typically, Medicare pricing is much better than what is available to employees through their work. Medicare plans are generally much less expensive because the government is helping pay the monthly premium.  Furthermore, these Medicare plans are very well received by the members who enroll in them. Members often experience less out of pocket expenses when on Medicare.

HealthyMarks for Business is Offering Plan Evaluation Comparisons

Are you unsure whether or not you’d be better off on Medicare or your Employer Insurance?  Reach out to HealthyMarks for one of our free services: Plan Evaluation Comparisons. If you are not sure whether your plan is better or worse than offered through Medicare, send your company’s health insurance plan details to our team and we will help you through the decision. Our team takes an objective approach to health insurance evaluations. We focus on the total monthly cost and how much financial exposure you’ll face if you do end up with a large medical bill.

Small Group Insurance Plans – Less Than 100 Employees

When an Employer has less than 100 employees, this business is considered a “Small Group”.  Small Group Insurance plans are priced much higher than Medicare plans. In San Diego, HMO plans for 64 year olds can be as much as $800.  PPO plans are even pricier and start at about $1000 per month.  In San Diego, Medicare Supplement Plans (full nationwide PPO plans) are typically about $350 for a newly enrolling 65 year old.  Advantage Plans (which are more similar to an HMO plan) are closer to $200 per month.

Employers with 20 Employees or Less

When an Employer has 20 employees or more, Medicare considers this as a “qualifying health insurance” so you are not required to enroll in Medicare.  However, if your employer has less than 20 employees, you will be required to enroll in Medicare or face penalties in the future.

Employers offering Contribution

If your employer is offering a contribution towards your health insurance, this may sway your decision. Typically, the Medicare plan will be a better option but you may be receiving very discounted insurance through your company because your employer is paying a large amount of the costs. In this scenario, it is always worth a Plan Evaluation.

Employees with Dependents on their Group Insurance

Having a spouse as a dependent on your group insurance plan may impact whether or not you switch to Medicare. Unless your spouse is also an employee at your company, you cannot enroll yourself in Medicare while your spouse stays on the employee plan. You similarly cannot have your spouse continue their dependent plan with COBRA while you the employee moves on to Medicare. Instead, when you enroll in Medicare, your spouse can then enroll in his/her own individual market health insurance plan because losing insurance is a “qualifying event” to switch to a new plan. However, maybe your spouse doesn’t want to make that switch or your employer is contributing towards both you and your dependent’s insurance premiums. In this scenario, consider speaking with a HealthyMarks professional for a Plan Evaluation.

Large Group Insurance Plans – More Than 100 Employees

Large Group Employers have access to health insurance plans that the rest of us do not. Many of the large group plans have what is called “Composite Rating.”  Or in other words, these plans do not get more expensive when you get older.  You will pay the same as a younger employee. Because of this, some of these plans are competitive with the Medicare plans in San Diego. If you are working for a large company, the monthly insurance price is good, and your out of pocket medical expenses are reasonable, you may have a better plan than what is available through Medicare.

When you are looking to switch to Medicare, consider the amount you are paying and how much your employer is paying each month, consider whether or not it will impact your dependents or not, and consider whether Medicare offers better coverage to your current insurance. When you are ready to compare plans or enroll, HealthyMarks will be happy to help.

Keaton Marks

Keaton Marks is the owner and CEO at HealthyMarks including the medicare team. Keaton was born and raised in Encinitas. He often rode his bike through town and to the local beaches like Moonlight. Keaton knows it is important to have a local resource, someone who understands the area, the hospitals and networks of doctors. Keaton is proud to be a local Medicare broker who is able to assist the people in his town when selecting medicare plans.

Keaton believes one thing above all else: “Medicare is confusing… but it doesn’t have to be! That is where HealthyMarks Medicare comes in” Please contact me with any questions.