Medicare Guidance for Employers and Business Owners
Medicare changes the benefits picture for employees who are 65 and older, and for owners who are approaching or past that milestone. We help you coordinate Medicare with the rest of your benefits strategy so the right coverage is in place.
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Medicare As a Part of Your Benefits Strategy
As more people keep working past 65, more employers find themselves with team members who are eligible for Medicare and a group plan at the same time. How the two work together depends on factors such as the size of your organization and whether an employee is still working. Generally, employers with 20 or more employees see their group plan pay first for active employees who are 65 and older, while smaller employers often see Medicare pay first.
Those rules shape real decisions for your employees and for your plan. Our agents help you understand where you stand so everyone can plan ahead instead of reacting at the last minute.
For Employers With Employees Over 65
Employees approaching 65 usually have questions, and the answers affect both their coverage and your plan. We help you and your team think through the decisions that come up:
Keep the group plan, add Medicare, or both.
We walk through how each path works for your situation so employees can choose with confidence.
Timing and enrollment windows.
Missing a Medicare enrollment window can lead to gaps or late enrollment penalties, so we help employees know what to watch for and when.
Prescription coverage.
Whether your plan’s prescription drug coverage is considered creditable can affect an employee’s Part D decision later. We share educational resources to help you understand this and refer you to trusted compliance partners for the required notices.
Health savings accounts.
Employees with an HSA have specific considerations once they enroll in Medicare, and it helps to raise them early.
For Business Owners and Self-Employed Professionals Over 65
You spent years building your business, and your own coverage deserves the same planning. For many owners, Medicare becomes the foundation of their health coverage at 65, and the details are worth getting right.
Still working?
If you are covered by a group plan through your own business, we help you decide when Medicare fits in.
Moving from an individual or ACA plan?
We help you plan the transition so there is no gap in coverage.
Enrollment timing.
We explain when to enroll and what can happen if you wait, so there are no surprises later.
Ready to have a conversation?
Prescription Drug Coverage, Explained Clearly
Original Medicare does not include most outpatient prescription drug coverage. A Medicare Part D prescription drug plan adds it. Plans differ in the medications they cover, the pharmacies they work with, and what you pay throughout the year, so the right choice depends on what you take today.
We help you compare Part D plans based on your medications and pharmacies. Plans change every year, so we also review your coverage during the Annual Enrollment Period, which runs from October 15 to December 7.
Prefer to start on your own? Our step-by-step guide walks you through enrolling in a Part D plan.
MEDICARE RESOURCES
IRMAA Sliding Scale Tables
Medicare’s version of “you make how much?”
Check the SSA’s chart to find your premium bracket—aka your IRMAA (Income-Related Monthly Adjustment Amount).
Compare Medicare Plans
Like to DIY? Use this tool to browse and compare Medicare Advantage (MAPD) and prescription drug (PDP) plans in your area—no pressure, just options.
Planning Ahead for Medicare?
LET’S TALK
Tell us about your team or your own situation, and we will start with a conversation about what comes next.
DISCLAIMER: We may not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.