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Medicare Plan Choices

Employer or Union Group Health Insurance

Some employer and union-provided health insurance policies can continue or switch over to provide coverage for you when you are 65 and retired. Contact your former employer or union for information on your plan.

Medicare has special rules that apply to beneficiaries who have group health plan coverage through their own or their spouse's current employment. Group health plans of employers with 20 or more employees must offer these people the same health insurance benefits under the same conditions that younger workers and spouses receive. If your group health plan (participation is based on current employment) denies you coverage, or offers you different coverage, call your State Insurance Department. See the Helpful Contacts section for the phone number of the State Insurance Department in your area.

If you or your spouse stops working and you are already enrolled in Part B:

  • Notify your Medicare carrier by phone or in writing that you or your spouse's employment situation has changed.
  • Give the carrier the name and address of the employer plan, your policy number with the plan, the date the coverage stopped and why.
  • When receiving health care services, tell the provider that Medicare is now your primary payer and should be billed first. Give the date your group health coverage stopped.

If you have employer or union-provided health insurance and disenroll from that group health plan to join another Medicare health plan, you may or may not be able to get the same policy back for the same premium.

Caution: If you or your spouse has health care coverage that supplements Medicare through a former employer or union, contact your benefits representative before you make a new health plan choice.

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