Can you have private insurance and Medicare?
If you want to know, "Can you have private insurance and Medicare at the same time?", the short answer is yes. Whether or not it is recommended depends on the type of Medicare plan you have chosen. Consider purchasing affordable private insurance with Medicare Parts A, B, and D. Alternatively, you can still use your employer-sponsored health insurance to fill any gaps in coverage with Medicare and reduce your out-of-pocket costs.
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UPDATED: Dec 14, 2021
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- You can have private insurance and Medicare coverage as soon as you are eligible for Medicare
- Depending on your work status and the size of the company you work for, you may be required to have Medicare as your primary form of health insurance coverage
- If you choose to have basic Medicare coverage, you should buy a private health insurance policy to expand your coverage and reduce any out-of-pocket costs for hospital stays and procedures
Can you have private insurance and Medicare at the same time? In short, you can have both private insurance and Medicare, but there are a few things you need to consider.
First, you need to plan when to enroll in Medicare. Once you turn 65 years old, you are eligible to enroll in Medicare. That is the case whether you have retired or you are still working.
If you already have an employer-sponsored plan, you might want to keep it. However, there are consequences to not enrolling in Medicare early.
Your chosen Medicare plan may have some coverage limitations. Therefore, you may need to compare some supplemental private health insurance plans to fill some gaps.
Learn more about how you can have private insurance and Medicare, plus some considerations for having dual health insurance policies. And if you would like to see rates from top Medicare partners in your area right now, enter your ZIP code into our free quote tool above.
How can you have private insurance and Medicare at the same time?
You can buy a private health insurance policy and enroll in Medicare with a few caveats. There are usually three types of situations where you can use a private health insurance policy while taking advantage of Medicare:
- You are actively employed past age 65 but enrolled in Medicare early.
- You have an Original Medicare plan but need to purchase Medigap insurance.
- While traveling, you have a Medicare Advantage policy, but you need to buy a private insurance policy.
Read on to learn more about each scenario.
Having Private Insurance and Medicare While Actively Employed
Depending on the company you work for and the size of that company, you may have already enrolled in a group health insurance plan. That is one form of private insurance, and it’s likely tied to a health management organization.
During that time, you may turn 65 and have a choice to make. You can either delay getting Medicare immediately or enroll while keeping your current insurance.
Generally, you are required to enroll in Medicare within six months after you turn 65. That is so you can avoid paying late fees should you sign up later. However, by law, your employer may not kick you off the company plan if the company has 20 or more employees.
Now, if you work for a company with fewer than 20 employees, your employer may require you to drop your employer-sponsored policy and go on Medicare.
However, you may still need to purchase another private policy to have adequate coverage and to lower your out-of-pocket medical costs.
Using a Supplemental Health Insurance Policy With Medicare
If you choose an Original Medicare plan (Parts A and B), you may also need to buy supplemental insurance. For one thing, you may need to purchase a standalone Part D plan for prescription coverage. Also, there are some things that Original Medicare will not cover.
Ultimately, a basic Medicare plan will not account for out-of-pocket costs. For example, you may have a chronic condition or need to undergo operations, rehabilitation, and emergency care.
These limitations present a health insurance coverage gap, so you may need to buy supplemental insurance, like a Medigap policy. A Medigap policy is a private policy from a health insurance company.
Depending on your state, you may have a choice among 10 standardized plans, lettered A, B, C, D, F, G, K, L, M, and N. These plans will not expand your Original Medicare coverage but will help you reduce your out-of-pocket costs.
Traveling as a Medicare Advantage or Medigap Enrollee
If you have Medicare Advantage (also referred to as Medicare Part C), you will choose a health insurance company from a list of Medicare partners. You will enjoy the type of benefits that Parts A, B, and D (prescription coverage) offer, plus dental, hearing, and vision.
If you travel, some Medicare Advantage plans may provide some coverage for medical expenses while you are abroad.
Some Medigap policies will also offer this type of coverage. Plans C, D, F, G, M, and N will provide up to 80% coverage for your medical expenses while abroad. Otherwise, you may need to purchase temporary or long-term health insurance until you return to the States.
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How does Medicare work with private insurance?
In other words, what is private insurance like for a Medicare recipient?
Your experience with private insurance should not be too different if you have Medicare coverage. It just depends on the following:
- The types of coverage you purchase
- What your insurance company will cover
- Which plan acts as the primary payer when you undergo major medical procedures
Having both plans may help you fill gaps in coverage, as regular health insurance plans may cover more procedures than Medicare. And if you are a Medicare recipient and you purchase a private health insurance policy, your Medicare will act as your primary insurer in some cases.
One such scenario is if you or your spouse works for a company with fewer than 20 employees. Also, if you have a private health insurance policy and your insurer is slow to pay out a claim, a private healthcare facility might bill Medicare first.
If your company has 20 or more employees, your group plan may be the primary payer. In that case, Medicare is your secondary insurance.
Should you use private health insurance while on Medicare?
Can you have affordable private insurance and Medicare if you sign up for Medicare later? You can, as you do not have to sign up for Medicare if you have private insurance and are working past 65.
However, if you believe you will use Medicare in the future, you are better off enrolling as soon as you are eligible to do so.
You will have to pay for Medicare when you turn 65 should you enroll. But with your early enrollment, there are several advantages you will have:
- You can use Medigap policies.
- You can choose a comprehensive health insurance policy regardless of your health history.
- Early enrollment can lead to reduced monthly payments, where applicable.
Can you afford all the out-of-pocket costs that come with procedures or pay for a health insurance policy that offers more coverage regardless of your health history? If so, you might not need Medicare.
Consider your potential monthly or yearly insurance rates, along with deductibles and copays. Also, think about the quality of care you can receive, especially if you have a chronic condition.
Ultimately, you will need to talk to a Medicare agent to determine which plan is best for your situation. Also, make sure to check the State Health Insurance Assistance Program website if you need local Medicare insurance counseling.
We hope that we have fully answered the question, “Can you have private insurance and Medicare?” In the meantime, if you would like to see rates from top Medicare partners near you, enter your ZIP code into our free quote tool below.