Coverage · Employer-sponsored health plans

Employer Group

How employer group health coverage coordinates with Medicare when you are eligible—or already enrolled—and what to verify before changing plans.

Primary vs. secondary

Medicare may pay first or second depending on employer size, your employment status, and whether coverage is through active work or retiree benefits.

Many people delay Part B while covered by an employer plan that pays primary. Missing the Special Enrollment Period can mean penalties.

If your employer drug coverage is creditable, you may delay Part D. If not, enrolling when first eligible helps avoid late-enrollment penalties.

Still working at 65
If you have employer group health coverage through your job or your spouse's job, you may be able to delay Medicare Part B—and sometimes Part D—without penalty when the employer plan is primary.
Creditable drug coverage
Employer plans must tell you yearly whether prescription coverage is creditable. Keep that notice if you delay Part D enrollment.
Retiree or COBRA coverage
Retiree health benefits and COBRA have different Medicare coordination rules. Confirm which payer is primary before changing plans.
Small employer plans
Employers with fewer than 20 employees (fewer than 100 for disability) often have different primary-payer rules than large group plans.

Resources

When employer coverage ends

When you leave employer coverage, you typically have a Special Enrollment Period to enroll in Medicare or choose MAPD or Standalone Part D.