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Medicare vs Employer group plan, which one is better?

One of the most common questions that we are asked is: Medicare vs Employer group plan, which one is better?

The simple answer is “it’s depends”.

Every person that reached the age of 65, and paid Medicare taxes at least 40 quarters of his/her working life, is entitle to get Medicare part A free of charge. When that person will reach 65 years of age, they will enrolled into Part A that covers inpatient care. Inpatient care includes care received while in a hospital, a skilled nursing facility, and, in limited circumstances, at home. Part A has $1364 copay for every hospitalization, and vary copays if an event will be for more than 60 days.

They will also have the ability to enroll into Part B. Part B covers doctor visit and related health costs. It has a $135.50/premium and an annual deductible of $185 and 20 coinsurance after deductible is meet.

On top of original Medicare (part A and B), one could enroll into a Medicare advantage plan or a supplement. Either one will reduce the out of pocket charges, left by Medicare, in various ways. Those charges do not include the additional drug liability that different people will have in different shape and forms.

Employer group plan usually has a premium, with various copays/coinsurance for different services and treatments.

Most of the time, the employer group plan premiums and copays will be higher than the premiums and copays in Medicare. When our agents evaluate which way is better, we take the whole health cost picture an individual will have with Medicare, and we compare it to the one he/she has with the employer plan.

Cost is not the only ingredient for the final decision. Doctor’s network, drug coverage, and accessibility to services could be some of the additional forces that could lead to choose one way or the other.

If you have any further questions about Medicare vs Employer group plan, feel free to contact us at Senior Benefits of GA for a free evaluation to see where you stand, and what you should do if you face that issue.