How Medicare Works With Other Health Insurance

By planmedicare1 - April 7, 2016

By now you know that when you turn 65 years old, you are eligible for Medicare. But what happens if you already have health insurance? How does Medicare work with other health insurance? The answer depends on the type of coverage you have.

GROUP HEALTH INSURANCE FROM YOUR EMPLOYER: If you are a currently employed at a company that offers group health insurance, and you are turning 65, you have two options. You can either stay on your existing employer health insurance, and delay Part B, if you want to avoid paying Part B premiums until after you retire. If you do decide to sign up for Medicare as well, then your employer plan becomes your primary insurance and Medicare becomes your secondary insurance. This is only the case if your company has 20 or more employees. If the company you work at has fewer than 20 employees, than Medicare will become your primary. One thing to note about employer health insurance, is that if your spouse, or family is on your employee health insurance, and you decide to go on Medicare, then your family will need to go on Cobra coverage. They will not be able to stay on your employer group insurance, if you go off of it.

RETIREE HEALTH BENEFITS: If you have retiree coverage from a former employer or union, and are Medicare eligible, then Medicare Parts A & B will always be your primary. Your retiree coverage becomes your secondary or supplemental insurance that covers some of the services that Original Medicare does not cover. If you have retiree coverage and want to know specifically how it will work with Medicare, then contact your retiree plan and request information on how it fits with Medicare. One thing to note, is that if your retiree plan provides “creditable” drug coverage, then you don’t need to take a Part D drug plan. You can find out if your drug coverage is creditable by asking your retiree plan.

FEDERAL RETIREE HEALTH BENEFITS: If you have retiree coverage by the federal employee health benefits program, then you do not need to join Medicare Part B when you retire. However, if you decide at a later date that you do want to enroll, (if your existing plan gets too expensive let’s just say), then you will be penalized and have to pay a late penalty. If you keep your plan and join Medicare as well, then Medicare will become your primary insurance. Similarly to regular retiree health coverage, if your federal employee health benefits program includes “creditable” drug coverage, you do not need to enroll in a Part D drug plan.

VETERANS HEALTH BENEFITS: For those who have VA coverage, Medicare Part B enrollment is not mandatory, but the VA does recommend it. Having a Medicare plan helps increase coverage for vets, beyond just VA facilities. Let’s just say you need to go to a non-VA facility, in an emergency, having Medicare will help cover the costs associated. If you decide to wait to enroll in Medicare, you may be faced with a Part B late penalty. Those who do have VA coverage do not need to enroll in a Part D drug plan, and if you lose your VA coverage and need to enroll in a Part D plan, you will not be penalized.

MILITARY RETIREE HEALTH BENEFITS: If you are on active duty, and 65 years old or older, you and your spouse will receive TriCare benefits. When you retire from duty, and are 65 years old or older, you and your spouse automatically switch from TriCare to TriCare for Life (TFL) and you must enroll in Medicare Part A & B. At that time, Medicare will become your primary insurance, and TFL will become your secondary or supplemental insurance. When you have TFL as a supplemental insurance, then you do not need to enroll in a Part D Drug Plan.


Medicare can be confusing, but the licensed agents at Plan Medicare make it easy to understand how Medicare works with your existing health care coverage. Call a licensed agent at 516-900-7877 to learn more about your specific situation.

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