A group health plan, also known as employee health coverage, is a type of health insurance provided by companies or organizations for their full-time employees. These health plans cover various healthcare services and, in some cases, may also cover dependents and spouses.
Employees who are over 65 and currently have a group health plan can also enroll for Medicare. They can either choose to enroll for Medicare as soon as they become eligible or delay their enrollment. Since there are people who continue to work after turning 65, it is possible to have group health insurance and Medicare at the same time.
Both insurance plans can work together to cover the necessary healthcare costs. Depending on the company’s size, either Medicare or the group health plan will serve as the primary insurance.
Features of a Group Health Plan
Companies offer group health plans to their active employees. Most group health plans have the following features:
- They must cover employees with preexisting health conditions at the same rate.
- Even if the employee falls sick, the insurance plan must provide coverage.
- Free preventive screenings or healthcare visits.
- No limits on essential health benefits.
Also, the group health plan must conform to the standards of conduct of the U.S Department of Labor.
Group Health Plan and Medicare
Original Medicare, or Part A and B, provides hospital and medical insurance, covering your inpatient and outpatient costs. With employer coverage, you can choose to enroll in Part A and delay your enrollment in Part B. Many individuals are usually automatically enrolled in premium-free Part A, so you will only have to pay the cost of your employer insurance by going this route.
If there are fewer than 20 employees, Medicare will serve as the primary insurance. However, if there are 20 or more employees, Medicare will serve as the secondary insurance. The primary insurance will pay out first, while the secondary insurance will cover the remaining costs. Also, suppose your group health plan covers dependents or spouses. In that case, Medicare will cover individual healthcare costs while the group health plan will cover the dependents.
If your employer has less than 20 employees, you must sign up for Medicare during your Initial Enrollment Period to avoid the late enrollment penalty. However, many individuals are automatically enrolled in Medicare, depending on if they meet the necessary requirements. If there are more than 20 employees, you can choose to delay your Medicare enrollment without paying the late enrollment penalty.
Need More Information?
At Bend Medicare, we have a team of dependable professionals to help you with the process of selecting the right Medicare plan. To schedule an appointment, contact us today at (541) 201-7740.