Do Employers have to Provide Insurance to Seniors with Medicare?
Does an employer have any responsibility for an employee’s medical insurance if the employee is a senior on medicare and has a supplemental policy?
Answer
According to the ObamaCare Employer Mandate, all businesses with 50 or more full-time equivalent (FTE) employees must provide affordable health insurance to at least 95% of their FTE employees and dependents up to the age of 26. This requirement includes seniors with access to Medicare if they are qualifying, full-time equivalent employees.
It's the employees choice to choose between Medicare or the coverage you offer. They can take your coverage, and still get Medicare Part A (while deferring Part B without a penalty). If the employer has 20 more employees, and does offer coverage, then they must also offer it to the 65 plus employee.
You can provide employee benefits that include contributions toward supplemental Medicare as well, but still must offer the employee the same plan as everyone else.
For employees, if a group health plan doesn't pay all of your bill, the doctor or health care provider should send the bill to Medicare for secondary payment. Medicare will look at what your group health plan paid, and pay any additional costs up to the Medicare-approved amount. You'll have to pay whatever costs Medicare or the group health plan doesn't cover.
Be sure to learn more about your options when you have both employer-sponsored health insurance and medicare options.
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Very confusing. I’m a retiree over 65 and I just want to know if an employer is required to provide me with insurance. Save the detail about deferring Part B for last.
Essentially the employer will offer coverage based on hours, but if you are over 65 and have access to Medicare then you get to make your own choice. The answer is detailed and this CMS approved page explains it well: https://www.anthem.com/ca/health-insurance/medicare/medicare-plans/working-at-65-medicare-employer-health-insurance/
Is an employer required to provide insurance after 65 when they did so prior to age 65. Signed up for medicare – is the employer obligated to pay the premiums? The prior question was not answered.
Employers must offer a plan to over 65 if they otherwise would offer a plan, and they can pay a portion of supplemental Medicare… but I don’t think they can pay a portion of original Medicare.
Learn more at Medicare.Gov: https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/employer-coverage/i-have-employer-coverage.html
And at Medicare.Com (private site run by eHealth I think): https://medicare.com/resources/medicare-and-employer-based-health-coverage/
I’m 66 and enrolled in Parts A and B. I’m a full-time employee in a business with more than 50 full-time employees. I’ve moved out of the service area of the group health plan offered by my employer. That insurance is no longer available to me. Can my employer pay for a Part C plan offered where I live or reimburse me for the Part C plan if I purchase it? I would be the only employee on the plan.