Older Worker's Options for Health Insurance Coverage

By Bethe Growe and Nancy Dilley | St Louis Post-Dispatch (MO), December 2, 1993 | Go to article overview

Older Worker's Options for Health Insurance Coverage


Bethe Growe and Nancy Dilley, St Louis Post-Dispatch (MO)


Q. If I continue to work past age 65, will my employer have to keep me on its group health insurance plan? I've worked for this company more than 20 years and have excellent coverage that I don't want to trade for Medicare. Also, a co-worker told me that I can't even get Medicare if I'm working. Is this true?

A. Under the present Medicare rules, if you continue to work full time past age 65, your employer may be required to keep you on its group health plan as your primary health insurance. The company's obligation depends on the number of full-time workers it employs - the magic number is "20."

If the company has 20 or more employees and you continue working full time past age 65, you must be offered the same health insurance benefits the company offers to its younger employees. But working and staying on the group health plan won't preclude you from Medicare coverage altogether; your co-worker gave you some incorrect information.

Here's how Medicare and your employer's group health plan could work together:

First, given your work history, once you're 65 you'll be entitled to "Medicare Part A hospital insurance" at no out-of-pocket cost to you, no matter what your current employment status is. Medicare hospital insurance generally covers certain inpatient hospital care and some inpatient care in a skilled nursing facility, home health care and hospice care.

But if you're covered by your employer's group health insurance when you have Medicare hospital insurance, Medicare will assume "secondary payer" responsibility. This means that your employer's insurance will pay first on any covered bills you may incur. Medicare, as your secondary insurer, would then pay for those health-care expenses that are covered by Medicare hospital insurance and not picked up by the group insurance plan.

Second, even if you opt to continue working and stay on the company insurance plan, you can still pay a monthly premium to have "Medicare Part B medical insurance" assume secondary payer responsibility for certain medical costs. Medicare medical insurance generally covers some doctor's services and many other medical services and supplies that are not covered by the hospital insurance part of Medicare. …

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