Can My Parents Get Medicare and Other Insurance at the Same Time?
Older people sometimes hesitate to ask questions, especially when it comes to their finances. That’s why it’s a good idea for you to get smart about your parents’ health insurance options, especially if they have Medicare. That way, you can be a good resource when they’re not sure how to manage their health care.
It’s not uncommon today for people to work past age 65, when Medicare eligibility kicks in. According to the Bureau of Labor Statistics, about 20% of those age 65 and over are either currently employed or looking for work. If that’s the case for one or both of your parents, it’s normal to wonder how Medicare works with other insurance.
This article explains how Medicare works with other types of coverage and what you can do to make sure your parents’ coverage works with their financial situation.
If you parents have Medicare and other insurance at the same time, they may get more comprehensive benefits than if they had Medicare only.
What is Medicare?
Medicare is government health insurance for people age 65 and over, and younger people with disabilities. U.S. citizens and permanent residents are eligible. Original Medicare has two parts: Part A, which is hospital insurance, and Part B, which is health insurance. You can also choose to get your Medicare benefits through a Medicare Advantage plan, which is private insurance approved by Medicare. Medicare Advantage plans are more similar to employer plans your parents may have had on the job.
Can my parents keep their private insurance when they get Medicare?
If your parents are still working when they reach Medicare eligibility, the answer depends in part on the size of the employer. In businesses with fewer than 20 employees, Medicare is the primary insurer for people age 65 and over. In other words, if your parents don’t sign up for Medicare when they are first eligible, their employer group plan doesn’t have to cover any medical expenses. With larger employers 20 or over, the group health plan generally remains the primary insurer, although it’s good to confirm with the company’s benefits manager.
If your parents are covered by TRICARE, VA benefits, or a retiree group plan, they most likely need to sign up for Medicare as soon as they become eligible. In these cases, Medicare becomes the primary payer for all health claims. When Medicare is the primary payer, secondary payers such as VA benefits or group plans only pay after Medicare pays its share.
If your parents got private health insurance on the insurance marketplace, they should also sign up for Medicare as soon as they become eligible. Once someone’s Medicare coverage begins, he or she is no longer eligible for premium subsidies on the exchange.
Can my parents add other insurance coverage to Medicare?
Original Medicare has pretty comprehensive coverage for preventive health care and services to diagnose and treat most diseases. What it lacks, however, is coverage for things such as routine vision and dental care that is often included in employer plans. If your parents choose Original Medicare, they may be able to buy a separate stand-alone plan to help offset the costs of those services.
Medicare Supplement Insurance Plans are private plans that help cover out-of-pocket costs such as deductibles and coinsurance under Original Medicare. They won’t cover out-of-pocket costs associated with a Part D plan, however. Medicare Supplement also cannot be used with Medicare Advantage.
Is Medicare Advantage like private insurance?
Medicare Advantage is private insurance. Medicare Advantage plans must offer the same benefits as Original Medicare, at a minimum, although most have additional benefits such as routine vision, dental, and hearing coverage.
Medicare Advantage functions like employer plans because the companies that offer these plans usually also offer employer plans. You usually have just one annual deductible with Medicare Advantage, unlike separate deductible for Part A and Part B with Original Medicare. Medicare Advantage plans usually have copayments when you visit the doctor or hospital. Original Medicare Part B charges a 20% coinsurance amount. There is also an annual out-of-pocket maximum with Medicare Advantage plans. There is no such limit with Original Medicare.
There may be a separate monthly premium for Medicare Advantage in addition to your normal Part B premium. You may also have to see network providers depending on the plan you choose.
To look for a Medicare plan in your area, enter your zip code on this page.