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Medicare Advantage & Working

Medicare Advantage plans, also known as Medicare Part C, are health insurance plans operated by private insurance companies. These plans offer the hospital and medical coverage provided by Medicare Parts A and B, Part D prescription coverage and additional optional benefits, such as vision or dental care. Medicare beneficiaries who choose Medicare Advantage plans pay a monthly premium in addition to their Medicare Part B premium charged by the government.

  1. Choosing a Medicare Advantage Plan

    • Most Medicare beneficiaries are Americans over age 65, who have worked for at least 10 years in Medicare-eligible employment. Most people do not pay a premium for Medicare Part A hospital insurance, and enroll as soon as they are eligible. Some opt to put off enrolling in Medicare Part B because they are still working and receive health benefits through their employers. If you receive employer-sponsored health insurance, you most likely do not need a Medicare Advantage plan. Once you stop working, or if your employer discontinues insurance coverage, you have eight months to enroll in Medicare Part B or a Medicare Advantage plan.

    Enrolling in a Medicare Advantage While Working

    • In general, you can only join a Medicare Advantage plan during your initial Medicare enrollment period, which begins three months before you turn 65 and continues for four months after your birthday, or during the annual election period each fall. If you are still working during this period, check with your company's insurance representative to weigh your options to ensure you have adequate coverage. In general, once you enroll in a Medicare Advantage plan, you lock into that plan for a full year. You cannot return to your employer's coverage if you do not like the MA plan, or if you start working for an employer with better coverage options.

    Comparing Medicare Advantage and Employer Plans

    • If you are still working at age 65 and have health insurance through your employer, compare your current coverage and costs to the Medicare Advantage options available in your state. In some cases, it may be more cost effective for you to opt out of your employer's coverage and purchase a Medicare Advantage plan. Remember, you must pay the Medicare Part B premium each month in addition to the cost of the advantage plan. In addition, advantage plans only cover the Medicare beneficiary. If you have dependents, such as a spouse or children covered by your employer's plan, opting out may affect them.

    Low Income Assistance

    • Even if you are working, you might qualify for assistance in paying for your Medicare coverage, including a Medicare Advantage plan. Some private insurance companies offer Medicare special needs plans for those who receive Medicare and Medicaid. Beneficiaries under these plans receive extra help paying Part B premiums, and the Medicare Advantage plan premiums for little or no cost. Your state health insurance program or local area agency on aging can help to determine your eligibility.

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