Medicare is a government health insurance program administered by the Centers for Medicare & Medicaid Services for those who are 65 or older, under 65 with certain disabilities, or for those who have End-Stage Renal Disease at any age. With around 40 million Americans participating, Medicare is the largest health insurance service in the country.
It is important to recognize when or if you need to elect Medicare if you are 65 or older and actively employed, or if you are a spouse (65 or older) of an actively employed individual. If you do not enroll correctly, you may be subject to penalties by Medicare and claims could be denied or partially paid.
If you are collecting Social Security benefits, you should be automatically enrolled in Medicare Part A when you turn 65. If you are not collecting Social Security benefits, you will need to contact the Social Security office to enroll in Medicare or you can enroll via the web at socialsecurity.gov/medicare.
Number of Employees | Who Owns the Policy | Primary Payer |
---|---|---|
All entities employ less that 20 employees | At least one employer has more than 20 employees | At least one employer has more than 20 employees |
One policy for all entities | One policy for all entities | Each entity has its own policy |
Medicare is primary for all entities. Employees should enroll in Medicare. | Employer is primary. Employees not required to enroll. | Employers is primary ONLY for the entities that have +20 employees |
Inpatient Care: Hospital stays, skilled nursing services, hospice care, etc.
Optional Add-on
Prescription Drug Plan
Inpatient Care: Doctor visits, lab tests, diagnostic screenings, etc.
Insurance Pays for services NOT covered by Part A or Part B.
Includes same coverage as Original Medicare (Part A & B) and may include extras such as prescription drug coverage (Part D), vision, hearing, dental care and more. Purchased from Medicare approved, private provider.
Optional Add-on
Includes same coverage as Original Medicare (Part A & B) and may include extras such as prescription drug coverage (Part D), vision, hearing, dental care and more. Purchased from Medicare approved, private provider.