Can You Have Private Insurance and Medicare?
People sometimes ask “Can you have private insurance and Medicare? How does that work?” In some cases, you may be able to have both Medicare and private insurance, as we’ll explain.
Private insurance and Medicare: an overview
Private health insurance is sold by private insurance companies – not by the government.
Medicare Part A and Part B are known as Original Medicare, also called traditional Medicare. It’s provided by the federal government.
- Part A is hospital insurance, and most people don’t have to pay a monthly premium for it. So, many Medicare beneficiaries decide to enroll in Part A even if they have employer-based insurance.
- Part B is medical insurance. Most people do pay a Part B monthly premium. Also, many people are still covered by employer- or union-based health insurance when they become eligible for Medicare.
If you can have Medicare and private insurance, how does that work?
If you have private health insurance along with your Medicare coverage, the insurers generally do “coordination of benefits” to decide which insurer pays first.
For example, suppose you’re enrolled in Medicare Part A and Part B, and you’re still covered through an employer, or your spouse’s employer.
- If the employer has 20 or more employees, the group health plan usually pays first.
- If the employer has fewer than 20 employees, Medicare usually pays first.
Important: If you’re eligible for both Medicare and private insurance such as a retiree group plan, check with the group plan to find out how your coverage may change when you’re eligible for Medicare.
Should you have Medicare and private insurance, or should you delay Medicare enrollment?
If you’re eligible for Medicare and have private health insurance, there may be some situations when it may make sense to delay Medicare enrollment, especially in Medicare Part B. Part B is medical insurance (for doctor visits and other services.) So, you might find yourself paying two monthly premiums – one for your plan and one for Part B – for very similar coverage.
So, some people choose to keep the group health plan and delay enrollment in Part B. But it really depends on your situation. Before you decide to delay Part B enrollment, call your private insurance plan and ask them how your plan works with Medicare. You can also contact eHealth and ask one of our licensed insurance agents for more details about delaying Part B enrollment.
If you decide to delay Part B enrollment, make sure you sign up as soon as your private insurance coverage ends, so you can avoid a penalty for late enrollment in Part B.
Medicare and private insurance: Medicare Supplement
Medicare Supplement (Medigap) policies are sold by private insurance companies to work alongside your Medicare Part A and Part B (Original Medicare) benefits. These plans can help pay your Original Medicare out-of-pocket expenses, such as deductibles, copayments, and coinsurance. Read more about Medicare Supplement plans.
eHealth’s licensed insurance agents would be happy to help with any questions you may have about private insurance and Medicare. If you’d like to compare Medicare health plans or prescription drug plans, just enter your zip code on this page.