Retiree Health Coverage and Medicare

Published by: Medicare Made Clear

When you think of health coverage after retirement, you probably think of Medicare. But some people may also have access to retiree health coverage. So, what is retiree health coverage and how does it work with Medicare?

Retiree health coverage is health insurance that some employers, unions and trusts may offer to retiring employees and their spouses. Typically, it is group health insurance similar to plans offered to active employees. Eligibility, enrollment, coverage and other rules are specific to each employer’s retiree plan.

Do I Need Medicare If I Have Retiree Health Coverage?

Even if you have a retiree health plan, you most likely need to sign up for Medicare. Depending on the plan, you may need to sign up for Part A and Part B, or just Part A (you must be eligible for Part B). Retiree health coverage might not pay some medical costs during any period in which you were eligible for Medicare but didn’t enroll.

For people who retire before they are eligible for Medicare, retiree health coverage may serve to span the gap between employer health coverage and Medicare. When Medicare eligibility begins, the retiree plan or the coverage may change.

Learn More About Eligibility

It's important to know what to do when you're eligible for Medicare.

Learn More

How Does Retiree Health Coverage Work with Medicare?

Retiree health coverage may help cover some of the costs that Medicare doesn’t. It may also help cover some services that Medicare doesn’t cover.

Some retiree plans are Medicare Advantage plans. These plans provide all the same coverage as Original Medicare (Parts A & B) and often additional benefits and features such as prescription drug coverage and dental, vision and hearing care.

For prescription drug coverage, it’s important to know whether your plan provides creditable drug coverage. If it doesn’t, find out what your options are. Medicare Part D has a late enrollment penalty if you don’t have creditable drug coverage for more than 63 days.

Now that you have a quick overview of Medicare and retiree health coverage, check out this video on Medicare and group retiree coverage when enrolling in Medicare for the first time.

Medicare and Group Retiree Coverage

Do you need Medicare if you have retiree group health coverage? Watch this video for the answer.

Video transcript

A colorful cartoon female silhouette arises, facing left toward a speech balloon.

Text fades into the balloon.

ON SCREEN TEXT: If I have retiree group health coverage when I become eligible for Medicare, do I have to enroll?

The text fades out. The speech balloon slides off-screen to the left as the female silhouette slides offscreen downward.

A new speech balloon appears with text fading in.

ON SCREEN TEXT: This will depend on your retiree group health coverage and how it works with Medicare.

The speech balloon slides up, and a new one appears below it with text fading in.

ON SCREEN TEXT: Talk with your plan's benefits administrator to understand your options.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, this time indicating a change of speaker.

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ON SCREEN TEXT: What might I be able to do?

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below and indicates another change of speaker.

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ON SCREEN TEXT: Depending on how your retiree group health coverage works, you may--

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: 1. Be able to delay in Medicare Part A and/or Part B.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: OR
The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: 2. Be required to enroll in Medicare Part A and/or Part B right away.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating a change of speaker.

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ON SCREEN TEXT: If I'm able to delay enrolling in Medicare Part A and/or Part B Medicare when I'm first eligible, when would I sign up?

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating a change of speaker.

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ON SCREEN TEXT: It will depend on the rules Medicare has and the rules your retiree group health plan may have about enrolling.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: Ask your benefits administrator about timing and enrollment rules.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: If your retiree group health coverage allows you to delay enrollment, you'll need to make sure coverage is considered creditable by Medicare to qualify you for a Special Enrollment Period.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating a change of speaker.

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ON SCREEN TEXT: Can I have both Medicare and group retiree health coverage?

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating a change of speaker.

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ON SCREEN TEXT: Yes, it's possible to have both.

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ON SCREEN TEXT: How they work together though will depend on your retiree group coverage and what type(s) of plans are offered.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: Medicare Advantage and Medicare supplement plans are the most common types of retiree group health plans.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: You will need to determine how your unique retiree group health coverage and Medicare work together by talking with your benefits administrator.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating a change of speaker.

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ON SCREEN TEXT: How can I find out what my options are?

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating a change of speaker.

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ON SCREEN TEXT: To determine how your retiree group health coverage and Medicare work together, as well as timing and rules, speak with your benefits administrator.

The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker.

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ON SCREEN TEXT: To determine if you may qualify for a Special Enrollment Period or if you need to enroll when first eligible, contact Medicare at...

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ON SCREEN TEXT: www.Medicare.gov

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ON SCREEN TEXT: Additionally, speaking with your local State Health Insurance Assistance Program (SHIP) is a helpful resource for determining all your options and which are best suited to your healthcare needs.

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ON SCREEN TEXT: Medicare Made Clear® by UnitedHealthcare®

About the Author

Medicare Made Clear

Providing simple information and clear answers about Medicare insurance plans and choices for current and future beneficiaries, retirees, caregivers and health care providers.