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Why I enrolled in a Medicare Advantage plan even though I’m still working

By Mark Pabst

You may have asked yourself, "Can I work full time while on Medicare?” Well, you don’t have to be retired to claim your Medicare benefits. Generally, if you are over the age of 65 and you or your spouse have worked for at least ten years while paying Medicare taxes, you’re eligible to enroll in the program.

So, if you’re over the age of 65 and still covered by insurance provided through an employer, it might be time to consider your health insurance options. Here are some questions that may help with your decision:

  • Should I enroll in Medicare even though I still have coverage through an employer?
  • If I’m still working, when should I enroll in Medicare?  
  • Is one type of coverage superior to another?
  • What’s the best type of coverage for my financial health?

The answer to these questions is different for everyone. So, an important early step in finding the right answer for you is to compare your commercial and Medicare coverage options.

One way to do that is by talking with your Human Resources rep. Ask about your current employer plan and if other employer plans are available. Knowing your current plan will give you the information you need to compare your health plan options. And once you can compare apples to apples, it will be easier to make a decision.

You should also speak to a licensed agent in your area to learn more about the types of Medicare coverage available to you, including Original Medicare and the Medicare Advantage plans open for enrollment in your area.

To learn more about Medicare in general go here.

To learn more about Medicare Advantage go here.

Together, these conversations can help you determine what type of coverage is right for you.


How can comparing coverage help you? Lessons from Melissa’s story*

Shortly before her 65th birthday Melissa began receiving a lot of mail about Medicare. A widow, now in her late 60s, she planned to continue working for several years. But she also wanted to make sure she had the most cost-effective coverage for her particular situation. So, she decided to compare the benefits she received from her employer to her Medicare options.

Everyone’s Medicare journey is unique. But the questions Melissa asked about her employer-sponsored health plan and her Medicare options are a good example of the type of questions everyone with employer insurance who plans to work past age 65 should consider.


How to start the process

For Melissa, the process began by asking herself was it worth it to stay in her employer plan? Or was a different choice better for her health and financial needs?

Another important question she asked was what she wanted from her health benefits. She decided she wanted a plan that could help make her health care costs more predictable and meet her health needs.

“I said to myself, let’s take a look at Medicare options and see if there was a plan available that would give me similar coverage for a better price,” Melissa says. “Both Original Medicare and Medicare Advantage plans could provide coverage at a reasonable price, but it was also important that it was good coverage. I think most people don’t know that both types of Medicare are actually exceptional.”

To learn more about what Medicare costs go here.


How her choice changed her health

Ultimately, after comparing the costs and benefits of her employer coverage and her Medicare options, she chose to enroll in Medicare and then choose a Medicare Advantage plan. Ultimately, she made her decision because she’d have a better handle on her costs and would pay less for prescriptions.

Because her employer coverage was a high deductible health plan, Melissa often delayed care because she couldn’t be certain about the final cost. However, once she opted out of her employer coverage and enrolled in a Medicare Advantage plan, the more predictable costs for services meant she finally felt comfortable catching up on some important medical visits she had been putting off.

She also managed to save money on her prescriptions. Because she had selected a Medicare Advantage plan that included prescription drug coverage, often called an MAPD plan, she found out that a medication she took for a dry eye issue became much more affordable after switching plans. The lower out-of-pocket price meant that she could use the medication when she needed it rather than trying to make her prescription last as long as possible.

“Probably the biggest difference after I enrolled in Medicare Advantage was the costs of medications. I saved thousands per year. It was a game changer,” says Melissa. “I finally got access to my medications at a price I could afford.”

Ultimately, the decision to enroll in a Medicare Advantage plan with prescription drug coverage also gave Melissa greater peace of mind, making her more confident that she now has the peace of mind and the resources to do what’s best for her health, while staying within her budget.

“Before I became eligible for Medicare, I thought my coverage was fine,” she says. “But after I turned 65, I have to say that getting Medicare was really the best thing for me in so many ways.”


What’s the right choice for you?

While Melissa chose to leave her employer coverage and enroll in a Medicare Advantage plan, it’s important to remember any decision about your health is always a highly personal one.

Prices vary between plans, so Melissa’s experience may not reflect your costs or the coverage available to you. And of course, each situation is different. But doing your own research, talking to the right people and asking the right questions are still the best ways to begin making your own decision.

To learn more about what kind of questions you should ask about your health coverage if you’re working past the age of 65 go here.

Remember, if you’re still working, you’ve not only got options when it comes to your health care coverage, you’ve worked hard to earn those options. Now it’s time to pick the one that’s best for you.

To talk to a licensed agent, call 1-833-206-7237 (TTY: 711)

8 AM to 8 PM, seven days a week, from October 1 to March 31

8 AM to 8 PM, Monday to Friday, from April 1 to September 30

* Melissa’s story is an actual account of her Medicare experience while working past 65.

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