I've been on my employer's health plan but am retiring soon. What should I consider when moving to Medicare?

Question

Michael Ryan · Accepted Answer

First and foremost enroll in both Part A and B if you havent already done so.

Make a list your important doctors and prescriptions.  Contact an independant agent that works with many if not all of the carriers and different types of plans ie Med Sups, Medicare Advantage, Prescription Drug plans to narrow down your options for you.  While you can find most of this information independently, what you wont find is the detailed information that can make a difference in your coverage. Especially in 2025 with the significant changes in ALL of the prescription drug plans. You can start the rieview and application process as early as 3 months before needing it in place...

Focus on actual care thats needed now and will happen in the future.. One of those calls I get from time  to time starts with "remember that plan we talked about, I should have listened to you instead of goin out on my own"   There's no cost in working with an independant agent, there could be a significant cost in not doing so..

Steve and Sue Brauer · Answer

Hi, thanks for watching. So, if you're on an employer health plan, as long as you have what's called credible coverage, then you don't have to enroll in Medicare until you leave that group plan. But I always advise people to sign up at least for Part A, which is the hospital coverage, because if you work 10 years and you've paid into Social Security, then the Part A premium is free. That's the hospital piece of Medicare. When you leave your group plan, this is kind of a weird thing: you have up to eight months. Why anybody would want to wait eight months, I don't know, but you have up to eight months to sign up for Part B of Medicare. You only have two months to sign up for Part D, the prescription drug plan, when you leave your group plan. Why there's a discrepancy of six months, I have no idea, but that's how it is. So I always tell people, if you know when you're gonna retire, plan early and sign up so it coincides exactly.

Daniel Brechin · Answer

First thing is you need to call someone to show you what you are eligible for.  Second, talk to a licensed agent to find out what your choices are and get a long-term plan to cover your health care, which today can help you live to 90 years old or more.

I have been helping seniors since 1996.  
Danny Brechin
Contact me.

Norman Smith · Answer

Firstly, you will need to sign in for your Medicare Part B, which you have 8 months to do after your employment ends. Now you should have already signed in for your Part A, even if you had an Employer's Health plan. You will need that. Now, if you're going to a Medicare Advantage plan or sign in for your Part D for your Drug coverage, that must be done within 2 months. So don't delay there.
Then think about whether you want to take Original Medicare, then add a Supplement, or do you just want to do a Medicare Advantage plan? There are choices on both, so contact a professional like me who can walk you through the changes, the options, and the considerations you will need to take before making that decision.

Larry Dalton · Answer

When leaving a Medicare-recognized group plan at retirement, you have some of the same opportunities that you had when you turned 65. Most only have Medicare Part A, and some may carry Part A & B. However, the day you retire, and you are over 65, your time clock begins regarding upcoming penalties for failing to enroll. First, you have eight months to enroll in Medicare Part B to avoid penalties. However, you have only 63 days to sign up for a Medicare Part D prescription drug plan, or a guaranteed issue right for certain carriers on Medigap plans, with no pre-existing evaluation, and 63 days for a Medicare Part C Advantage plan. But you can't sign up for any of these plans until you sign up for Medicare Part B. Therefore, you should sign up immediately for Medicare Part B or the month before retirement, before your current coverage ends, to help you avoid a coverage gap. Now, with the retirement date, you have two choices: to go with Medicare Advantage coverage or a Medigap plan. This decision will determine how you go with Medicare Part D. Remember, this is for employees who stay on a company group health insurance plan of 20 or more employees past age 65.

Answered by Larry Dalton on May 5, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Terri Reagin · Answer

First of all I would recommend a local agent who can carefully comb through considerations such as budget for premium, doctor choices and out of pocket costs associated with your prescription drug benefits. Those would be the starting points for me sitting down with a retiree

Answered by Terri Reagin on September 12, 2025

Broker Licensed in OK, AR, CO & 6 other states

Answered by Terri Reagin Medicare Insurance Agent

Voss Speros · Answer

Voss Speros here, Greek god of Medicare. Medicare's all Greek to you? You're in luck, I'm Greek.

So the question today is: I've been on an employer plan and I'm retiring soon. What should I consider when moving to Medicare?

That's a good question, right? Because there's going to be a few things to consider. Are you going to take your Social Security at retirement? Yes, I hope so, because you're retiring. So apply for Social Security and Medicare.

Your employer plan has a deductible, premiums, and co-payments. If you go on an Advantage plan, it's like your employer plan with the deductible. But you have a guaranteed issue for going on a supplement plan if you're going on Part B for the first time. So look into that.

Also, you just need to know what you're going to lose with your employer plan. What other ancillary benefits did you have over there? Dental, vision, hearing? Well, you might keep that, but if you go to Advantage, you don't have to keep that.

So really, you need to apply for Part B if you don't have it. If you don't have either, apply for Part A and Part B, and then get your Social Security. You can do all that in your SSA.gov platform. When you create a login for that, you can set all that up in there. You can go in there and apply for everything.

If you're not checking your Social Security, you're going to have to set up a payment account to pay for your Part B premium. If you go on a supplement, you're going to have to pay for your supplement plan separately from your Part B premium. If you want an Advantage plan, there's no cost to those. But if there is, that comes out of your Social Security, if you're okay with that.

I think that covers most of it. If you have any other questions, just give us a call. Be more than happy to help.

George Ibanez · Answer

The first thing that you need to decide is if you prefer to go on a traditional Medicare Supplement plan or a Medicare Advantage plan.
Both plans are very different, and Medicare supplements are much more flexible. They cost a little more than Medicare Advantage plans, but they give you access to all doctors and hospitals because they have no networks, which means that you can go to any hospital or any doctor that you wish to go to, and there are no referrals needed or copays.

For more information, contact. George Ibanez.

Tony Capraro III · Answer

You should sit down with a Medicare Agent to go over all your options! I usually have folks come in for a quick meeting and see exactly where they are and what their plans and goals and objectives are! We'd be glad to help you! :)

Answered by Tony Capraro III on April 11, 2025

Agent Licensed in NH & ME

Answered by Tony Capraro III Medicare Insurance Agent

Ronnie Robinson Jr · Answer

Congratulations on your upcoming retirement plans. What I usually like to inform people who are new to Medicare is that there is a Medicare 101 that we are able to provide, where we go into the details of your options within Medicare and help you make a more informed decision with that option. So if that sounds good to you, please reach out.

Ray McCauley · Answer

Number one is cost
every morning number two our Benefits I will help you navigate to Medicare minefield please call me

Nikki Rowland · Answer

When retiring and moving from employer coverage to Medicare, you’ll need to time your enrollment correctly, understand how Medicare coordinates with your employer plan, and decide whether to add supplemental coverage. Planning ahead ensures you avoid penalties and gaps in coverage.

Answered by Nikki Rowland on November 24, 2025

Broker Licensed in SC, NC & OH

Answered by Nikki Rowland Medicare Insurance Agent

Justin Doherty · Answer

You'll need to evaluate how you want your coverage to work. If you want more comprehensive coverage that allows access to the most providers and least amount of hassle when obtaining services, a Medicare Supplement policy is a great option. For those that don't mind those types of hassles and want a lower monthly premium for their plan(s), Medicare Advantage plans are a good option.

Answered by Justin Doherty on September 26, 2025

Broker Licensed in PA, CO, CT & 11 other states

Answered by Justin Doherty Medicare Insurance Agent

William Gray · Answer

If you are over the age of 65 in order to avoid the penalties imposed you will need to submit the CMS-L564 form 

If you have income from 24 months ago that will put you in a high income earner you will need to fill out the form SSA-44 for an IRRMA reduction.

Mitzi Davis · Answer

There are several things to consider and its an Individual decision. It depends on things like what you are currently paying monthly, deductible, and Max out of pocket. Whether you are covering an under Medicare age spouse, and how far into your medical deductible you are when your Medicare would start.

Answered by Mitzi Davis on November 1, 2025

Broker Licensed in KS, AR, IA & 6 other states

Answered by Mitzi Davis Medicare Insurance Agent

Lilyana Uzdenova-Gomez · Answer

You should consider whether your employer will continue to offer creditable coverage for both parts B and D after you retire. If they do and it doesn’t cost more than medicare part B premium or offers benefits available nationwide without referrals you may want to consider staying with your employer sponsored plan instead of enrolling into part B and getting your own insurance. 
  There are other things to take into consideration which could not all be discussed in a few sentence response. I would highly recommend getting in touch with your local expert insurance broker and verifying your employer options with your current benefits administrator before finalizing your choices.

Adam Ashby · Answer

You need to think about a lot of things and you should start considering these things 90 days prior to losing your employer's health plan. First of all, you get the gift of Guaranteed Issue for a Medicare Supplement, this is your once in a lifetime opportunity to be protected by amazing coverage without the need to answer health questions - should you take advantage of that? Another thing you need to consider is your budget, for some moving from an employer plan to a Medicare Advantage plan is easier as they are already used to copays, networks and limitations. A full review of your NEEDS and WANTS in regards to your health is important. An agent cannot answer those questions in 5 minutes - if they do they are putting you where they want you, not where you necessarily should be. Find a Broker that will ask you about you and will help you be ready for the future.

Answered by Adam Ashby on May 19, 2025

Broker Licensed in CO, GA, IL & 6 other states

Answered by Adam Ashby Medicare Insurance Agent

Nicholas Depke · Answer

Retiring and moving from employer coverage to Medicare involves several moving parts, and the decisions you make in the first few months can affect your costs and coverage for years to come. The first thing to understand is that when your employer coverage ends due to retirement, you trigger a Special Enrollment Period that gives you eight months to sign up for Medicare Part B without facing a late enrollment penalty, but most people want to coordinate their start dates carefully so there is no gap in coverage. It is also important to know that COBRA does not count as qualifying coverage for purposes of delaying Medicare, so if you are considering COBRA as a bridge you need to be especially careful about how that interacts with your enrollment deadlines. Beyond the enrollment timing, you will want to think about whether Original Medicare with a Medigap policy and a Part D plan makes more sense for your situation, or whether a Medicare Advantage plan is a better fit, and that decision should factor in your doctors, your medications, your expected healthcare usage, and your budget. If your spouse is younger and still working, there may also be options worth exploring around their employer plan depending on how it coordinates with Medicare. People who have had good employer coverage for years are sometimes surprised by what Medicare does and does not cover, so sitting down with a knowledgeable agent before your retirement date rather than after is the smartest move you can make.

Answered by Nicholas Depke on March 29, 2026

Broker Licensed in NE, AZ, FL & 15 other states

Answered by Nicholas Depke Medicare Insurance Agent

Roger Werking · Answer

You need to decide if you want a Medicare Supplement Plan or a Medicare Advantage plan. Make sure you know your correct dates to sign up.

Marc Rheingold · Answer

Whether a Medicare supplement or Medicare Advantage Plan would be the best option for you. Find out when your health plan ends and apply for Medicare Part A and B before your health plan ends.

Maureen Gildea · Answer

Consider your health conditions before choosing a plan. You will have a guaranteed issue for a Medicare Supplement so that is something to keep in mind. A licensed professional would be able to go over the pros and cons.

Answered by Maureen Gildea on November 23, 2025

Broker Licensed in ME, FL & MA

Answered by Maureen Gildea Medicare Insurance Agent

Nathan Wright · Answer

When making the move from employer coverage to Medicare, you want to look at the full picture — monthly premium, co-pays, deductibles, and out-of-pocket maximums. What surprises most people is that many Medicare plans now start at a $0 premium, and in a lot of cases you end up with lower monthly costs and better coverage than what your employer was offering — you still pay your Part B premium, but overall it's often a very pleasant surprise.

Answered by Nathan Wright on May 23, 2026

Broker Licensed in TN, AL, FL & 10 other states

Answered by Nathan Wright Medicare Insurance Agent

Sherah Beasley · Answer

So listen, if you're working right now and have employer coverage, and you're trying to decide if you should move to a Medicare plan or stay with group coverage, the most important thing to remember is that Medicare requires you to always have some sort of credible coverage. Credible coverage can be group coverage or employer coverage that is equal to or better than what Medicare would offer. If you have that, and if you're unsure if you do, you can always ask HR. Your HR department should know that. But if you're unsure, you can always call a licensed agent too, and we'll walk you through what you currently have and what your options are.

Because if you come off your group coverage too soon and turn Part B on, now you're paying that monthly premium for something that may not be necessary if group coverage was better or the cost was lower. Usually, it's not, but sometimes it is. The other thing is you don't want to wait too long to turn Part B on and also lose your group coverage, because now you have a gap, and that's when penalties start to accrue.

So again, work with a licensed agent to look exactly at what your needs are, what your plan is, when you plan to retire, how your group coverage is currently treating you, how much you're currently paying monthly, and how much you're paying out of pocket when you use the services. Then look at all your options in Medicare. Usually, we say 80% of the time, clients do better moving to Medicare when it's time, not staying with their group employer plan. But every client’s different, so make sure you work with a licensed agent to determine what's best for you.

Jonathan Paddon · Answer

You will need to enroll in part A and B of Medicare through the Social Security Administration with a requested start date corresponding to the end of your employer health plan. You can do this online at SSA.gov or by calling your local Social Security office and scheduling a phone appointment. If you are over the age of 65, you and your employer will need to complete the form CMS-L564 Request for Employment Information to show you had employer coverage during the time you delayed enrolling in Medicare. This keeps you from having to pay the part B late enrollment penalty.

Answered by Jonathan Paddon on September 23, 2025

Agent Licensed in TN, AL, FL, GA, IL & MS

Answered by Jonathan Paddon Medicare Insurance Agent

Barry Baker · Answer

You should consider working with an agent so you can learn the nuances of Medicare. The differences between Advantage Plans and supplement insurance are stark. There can be a big impact on your health and medical treatment in the future. 
Also, work with an independent agent that has different carriers that give you more options rather than a captive agent with one company.
Above all, take your time and make a good decision to start, so you don't get fouled up later.


Thanks for the question,
BARRY BAKER
Contact me.

Traci Harward · Answer

I would recommend applying for medicare within 3 months of potential retirement. By doing this, you and insure that your medicare will be processed and approved in time for your retirement and avoid any lapse in medical coverage.

Answered by Traci Harward on November 17, 2025

Broker Licensed in UT, AZ, CA & 7 other states

Answered by Traci Harward Medicare Insurance Agent

Kevin McIntire · Answer

Timing is a big factor. Medicare plans only begin on the 1st of every month, so make sure your employer coverage extends to the end of the month before you start Medicare.

Joe Graves · Answer

There will be 2 answers to this depending on your age.  Under 65 -- you could go on your Employer's COBRA plan for a while, or you would get a plan on heatlhcare.gov which will give a subsidy based on income.  The higher the income, the more expensive healthcare.gov will be to you, and the affordable plans have VERY high deductibles.  Or you could purchase a short-term health plan, which doesn't cover pre-existing conditions but are about one-third the cost of other plans.  Or, if you attend worship services at least twice per week, you could explore Christian Sharing plans such as Medi-share or Samaritan Ministries.

Over 65, you could get another job that offers insurance, or you could possibly go on COBRA for a while, but your best option may be to go on Medicare where you could choose a Supplement or a Medicare Advantage.  If you decide to go on Medicare ask your employer to send you a CMS-L564E form.  They will know what it is.  Once you have this form, I can help you apply for Medicare online, and if I'm contracted in your state, I can help you explore your Medicare plan options. Get a prescription plan or you will be assessed a late penalty when you get one later.  I can help with this, too.

Bryan Monteagudo · Answer

The first thing to make sure is that if you are married that your spouse will have coverage before electing for Medicare. The best thing to do is to speak to an agent in your area. The next thing is to see what tax bracket you will be on if you join medicare the cost will be different depending on your tax bracket.

Answered by Bryan Monteagudo on February 23, 2026

Agent Licensed in FL

Answered by Bryan Monteagudo Medicare Insurance Agent

Diana Garner · Answer

There are several steps to take.  First, reach out to your employer's HR to confirm your group insurance is creditable for Medicare or not and to get the necessary information to complete your Social Security forms to enroll in Medicare Parts A & B as well as apply for your Social Security Retirement Income.

Second, you will need to decide whether a Medicare Supplement with a Standalone drug plan (Part D) or a Medicare Advantage plan is right for you.

You may check to see if you qualify for any low-income assistance.

Timothy Brown · Answer

The coverage options that you feel would best fit your healthcare needs and budget. A Medicare Supplement or a Medicare Advantage plan are the plan options the can address your needs.

Priscilla Ramos · Answer

When retiring, consider:

Timing your Medicare enrollment to avoid penalties
How your current employer coverage coordinates with Medicare
Whether you want Original Medicare or Medicare Advantage
Prescription drug coverage (Part D) and extra benefits like dental or vision

Vernon Jones · Answer

There are a few things you needed to consider as you prepare your move from an employer health plan to Medicare prior to retirement. I highly recommend you be aware that your employer`s plan coverage and costs, determine your Medicare enrollment period and decide which Medicare part A, B, D or Medicare Advantage and Supplement plans also known as Medigap fit your needs. You should contact your employer`s HR departments to make sure a smooth coverage transition and ensure you will not experience any gaps in coverage. But I do highly recommend that prior to your retirement that you sign up for Medicare Part B and hopefully if you already have Part A if you are age 65 or older to have a seamless transition into Medicare.

Answered by Vernon Jones on August 30, 2025

Broker Licensed in NC & SC

Answered by Vernon Jones Medicare Insurance Agent

Michael Yost · Answer

I would start applying for Part A/Part B 60-90 days before your retirement date. You want to give social security time to process your applications. You also want to review all Medicare options to see what your best route will be in choosing a plan.

Answered by Michael Yost on May 22, 2025

Broker Licensed in OH, AL, AZ & 27 other states

Answered by Michael Yost Medicare Insurance Agent

Barbara Patterson, CFP · Answer

You need to prepare 3 months ahead to enroll in Part B coverage and get a L564 form from your employer.  This will show you have had coverage since you turned 65.

Mal Varlack · Answer

Consider the timeframe. You have a limited time to enroll into Medicare after retiring and getting off your employer’s plan. Understand also the options of Medicare - Medicare Advantage versus Medicare Supplements [Medigap]. Get educated

Answered by Mal Varlack on August 17, 2025

Broker Licensed in FL, AZ, GA & 11 other states

Answered by Mal Varlack Medicare Insurance Agent

Daintee Hurst Dietz · Answer

Do you have additional Dependents, contributors and HSA and when to apply for A and B. Many factors your agent can help you with.

Donald Elliott · Answer

If you are 65 or older you should apply for Medicare effective the end of you group employer coverage. Carefully and thoughtfully consider all you Medicare options. If you are eligible for military or VA benefits, I recommend you utilize those programs to the maximum.

Answered by Donald Elliott on April 13, 2026

Broker Licensed in AL, GA & MS

Answered by Donald Elliott Medicare Insurance Agent

Kathy Detweiler · Answer

You want to take into consideration if you want a Medicare Supplement, which will fill the gaps of just having traditional Medicare. A Medicare supplement will allow you to see doctors all over the country and use any facility that accepts original medicare.
  There are monthly premiums you will have to pay. 

You must also sign up for a Prescription Drug plan to avoid penalties for not having one. You need one whether you stay on Original Medicare or go with a Medicare Supplement.

Neither of these offer hearing, dental or vision, you will have to get separate policies for those additional benefits.

Your other choice is enroll in a part C plan , also known as a Medicare Advantage plan. These usually work like your employment coverage, with deductibles and copays and maximum out of pocket. Most of them have 0 or low premiums, include the prescription drug plan and offer hearing, dental and vision. 

In the end it is up to you as a consumer to pick what is best for your lifestyle, on how healthy you are and what extra benefits you want or need.

Medicare is complicated so reach out to an agent and see how they can guide you for a plan best suited to your needs.

Hugo Luis Mion · Answer

The best thing you can do is consult a Medicare agent. There are many important factors to consider—such as your preferred doctors and hospitals, any chronic health conditions you may have, and whether you take specific medications. An agent can help you sort through all of this and guide you to the plan that fits your needs.

Answered by Hugo Luis Mion on January 4, 2026

Agent Licensed in FL

Answered by Hugo Luis Mion Medicare Insurance Agent

Deborah Zanelotti · Answer

What has your medical history been, if there are any that may be hereditary. How do you want to receive your coverage, go anywhere you choose or ok with Dr's in network. Are you gonna to travel or move?

Answered by Deborah Zanelotti on June 8, 2026

Agent Licensed in MD, CA, DC & 11 other states

Answered by Deborah Zanelotti Medicare Insurance Agent

Steven LaPorte · Answer

There are many topics to consider, but the most important with any plan is to make sure your doctors, clinics and medications are covered under the chosen plan. Also know that if someone has medical issues or travels for long periods, a supplement will give the more flexible coverage options but comes with a premium cost and can go up over time. Besides this there are still other things to consider in a Medicare plan.

Answered by Steven LaPorte on January 26, 2026

Agent Licensed in LA, MS & TX

Answered by Steven LaPorte Medicare Insurance Agent

Juan Beraldi · Answer

You should start your Medicare as soon as your employer coverage expires. You need to sign up for Medicare Part A (Hospital) & part B (Medical). You sign up online, by phone, or in person with Social Security. If you are already getting a Social Security benefit, they will enroll you in Medicare automatically, but if you’re not planning to get Social Security yet, then you will need to contact them and enroll. Your new coverage should start on the 1st of the month after you lose your employer coverage. 
Once you get this done, then you can enroll in a supplemental plan or Medicare Advantage, and a prescription drug plan. Your plan choice will start together with Medicare if you enroll before the effective date of your Medicare coverage. 
I can go more into detail regarding the difference between a Medicare Advantage plan and a supplemental plan. You can contact me and we can set up an appointment.

Sharon Bohlen · Answer

If you are 65 or older, you will apply for Part A and B, or B if you already have A. Do this through SSA.GOV. Then, you can meet with a licensed independent insurance agent to explore your coverage options for a Medicare Supplement/Part D or a Medicare Advantage (Part C) plan.

Answered by Sharon Bohlen on August 7, 2025

Broker Licensed in OH, FL, IN & KY

Answered by Sharon Bohlen Medicare Insurance Agent

Mary Brown · Answer

When retiring, contact Medicare.gov to enroll in Parts A & B on time, consider Medigap or Part D for gaps, compare Medicare Advantage vs Original Medicare, and use your Special Enrollment Period to avoid penalties.

Answered by Mary Brown on March 30, 2026

Broker Licensed in NJ, DE, FL & NC, OH, PA & TX

Answered by Mary Brown Medicare Insurance Agent

Andrew Kramer · Answer

First, you need to sign up for Medicare Part B, assuming you did not do that when you turned 65, which you should not have. There are 2 forms from CMS (Medicare) that you need to use. Have your agent email them to you, and after your employer has completed the employment form, bring them both to a local Social Security office 2 months before your retirement month. Be sure to indicate in Box #12 of the personal form, which date you want Part B to start. Then speak with your Medicare agent to start the process of understanding whether you want to stay in original Medicare and buy a supplement insurance policy (Medigap), plus a Part D Rx plan, or choose an Advantage plan which includes an Rx plan. It's very important that you make that choice within 63 days of losing your employer group health, so you don't get an LEP (Late Enrollment Penalty for Part D), but moreover, that you are not without health insurance!

Answered by Andrew Kramer on August 14, 2025

Agent Licensed in FL

Answered by Andrew Kramer Medicare Insurance Agent

Meghan Blankenship · Answer

That's a really important transition point - moving from employer coverage to Medicare can feel overwhelming, but if you break it down step by step, it becomes much clearer. Here are the key things to consider before you retire and enroll in Medicare:

Timing and Enrollment 

Initial Enrollment Period (IEP): Starts 3 months before you turn 65, includes your birthday month, and ends 3 months after.

Special Enrollment Period (SEP): If you're retiring after 65 and had employer coverage, you get an 8-month SEP to enroll in Medicare without penalties

Avoid late penalties: Missing these windows can mean permanent surcharges on Part B and Part D premiums

Coverage Decisions

Part A (Hospital Insurance): Usually premium-free if you or your spouse paid Medicare taxes

Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services. You'll pay a monthly premium. 

Part D (Prescription Drugs): Needed if you want drug coverage - compare plans carefully. 

Medicare Advantage (Part C): Private plans that bundle Parts A, B, and often D, plus extras like dental, vision, or wellness programs.

Carol Thompson · Answer

Consult with an agent/broker to see what independent plans are available in your coverage area to compare costs.

Marcie Barnes · Answer

Start the process of applying for Medicare 3 months before you leave your job.

Once you have your Medicare card call me to discuss your Medicare options

Charise Karjala · Answer

The question is, what should I consider when moving to Medicare from my employer-sponsored plan? The first item is budget. Your Medicare policy should cost you somewhere around $400, inclusive of your Part B premium, your supplemental G policy if you're 65, as well as a dental and vision policy. And that's it. There shouldn't be co-pays, co-insurances, or deductibles other than the Part B, so use that as your kind of benchmark. That, by the way, is pure PPO. It goes wherever Medicare goes—Mayo Clinic, Cedars-Sinai, Eisenhower, Johns Hopkins, Cleveland Clinic. Yes, you get the best of the best of the best.

The second item is that you get to choose if you want to participate in a Medicare Advantage policy. Those policies typically have a network, and there are managed care options. There are a few mapped plans that are PPO still roaming around out there, but most of them, in my experience over the last year, have been eliminated. So people are struggling to get into the place, which, of course, the Medigap policies are a perfect example of.

The third item is that Medicare does not cover eyes, ears, or teeth for whatever reason. Public policy doesn't seem to think that those things are important. I do, however, so I strongly suggest and recommend that my clients come and have a thorough evaluation of what they know to be true for their needs in the reasonably near future, and they secure whatever kind of insurance policies will give them some kind of return on investment or some kind of additional protection for each of those three areas.

There's so much for people to learn about with Medicare, but just understand first and foremost that Medicare is the biggest network in the United States. It's limited only to those people that participate in Medicare. And if you have a Medicare card and you have a supplemental card, you can go to anyone you want to see, regardless of city, state, county, or location. That's the fact. So when we compare that to employer-sponsored plans, generally speaking, our Medicare gap policy is substantially superior to that of an employer-sponsored plan. So if you're debating about getting off of your employer-sponsored plan...

Rodolfo Rojas · Answer

It varies on what coverage you would like. If you are in decent health, I would suggest Medicare Advantage. If you can afford Medicare, supplant-Median-that would be another option. You can also stay with Medicare Original, which is A-hospital, and B-Medical. However, you will have deductibles and it is 80/20 coverage.

Answered by Rodolfo Rojas on May 29, 2025

Broker Licensed in NV, AL, AR & 36 other states

Answered by Rodolfo Rojas Medicare Insurance Agent

Ben Washington · Answer

I've been on my employer's health plan but am retiring soon. What should I consider when moving to Medicare?  Will you be taking social security if not you need to signup up your part B,
Learn about original Medicare in comparison to to your company plan. Also learn about the different option like medigap and part C  (meicare advantage  plans) and part D (prescription drugs plan)

Cheryl Lyons · Answer

Congrats on your upcoming retirement! Transitioning from an employer plan to Medicare can be smooth if you plan ahead. Here’s the key stuff to consider:

1. Timing is critical

Your Initial Enrollment Period (IEP) for Medicare starts 3 months before your 65th birthday, includes the month of your birthday, and ends 3 months after.

Late enrollment penalties can apply if you miss your window.

Tip: If your employer coverage continues past 65 and has 20+ employees, you may qualify for a Special Enrollment Period (SEP) when you retire — no penalty.

2. Compare coverage and costs

Check what your employer plan covers vs. Medicare (doctor visits, prescriptions, hospital stays).

Look at premiums, deductibles, and out-of-pocket maximums for both Medicare and any supplemental coverage.

3. Part D for prescriptions

If your employer plan covers drugs, you may not need Part D immediately.

When you drop employer coverage, you can enroll in Part D during your SEP without penalty.

4. Consider Medigap or Medicare Advantage

Medigap (Supplement): Helps cover Part A/B out-of-pocket costs. Best for flexibility and freedom to choose doctors.

Medicare Advantage: Combines A/B + usually D, often with extra benefits like dental, vision, and hearing—but may have network restrictions.

5. Check provider networks

Make sure your doctors and preferred hospitals are in-network if you go with Medicare Advantage.

Medigap gives you freedom to see any Medicare provider.

6. Coordination of benefits

If you keep employer coverage while on Medicare, Medicare may be primary or secondary depending on your employer size.

Understanding this prevents unexpected bills.

7. Don’t rush—review all options

Compare Original Medicare + Part D + Medigap vs Medicare Advantage

Use the Medicare Plan Finder or consult a Medicare agent to find the best fit.

Sam Silva · Answer

As you retire and transition off your employer health plan, it’s important to enroll in Medicare Part B during your Special Enrollment Period to avoid penalties or gaps in coverage. Be sure to align your Medicare start date with the end of your employer coverage. In addition to Original Medicare (Parts A and B), you can choose to add a Medicare Supplement plan for more predictable costs, or enroll in a Medicare Advantage plan, which often includes extra benefits like dental, vision, and prescription drug coverage. Supplement or Advantage options are always available depending on your preferences, budget, and healthcare needs.

Answered by Sam Silva on June 24, 2025

Broker Licensed in FL, GA, NJ & 7 other states

Answered by Sam Silva Medicare Insurance Agent

Earl Beck · Answer

You shoukd make sure you know what the benefits of Medicare are. Your options for a Medicare health plan are either a Medicare Supplement plan or a Medicare Advantage plan. A MedSupp plan works with Medicare but does not have Rx Drug coverage. Woukd need a stand alone Rx Drug plan. A Medicare Advantage plan can have Rx Drug coverage. Works without Medicare.

Answered by Earl Beck on November 17, 2025

Agent Licensed in PA

Answered by Earl Beck Medicare Insurance Agent

Albert Smith · Answer

You should consider your finances, present health, and relocation plans. Then you can just weigh your options.

Donald Baker · Answer

If you are already 65 and have not established a social security account do so. If you have an individual account already and know when you want to retire, start the process within 90 days of retirement. Also obtain a letter from your employer showing you have credible coverage thru them.

Answered by Donald Baker on July 14, 2025

Agent Licensed in MN

Answered by Donald Baker Medicare Insurance Agent

Sonya Chandler · Answer

You need to consider the cost of Medicare.  You also need to consider the copays, coinsurance and cost of any medications you may be taking.

Daniel Underwood · Answer

I've been on my employer's health plan but am retiring soon. What should I consider when moving to Medicare?

Lakisha Bryant · Answer

Make sure you have no time gaps in health or prescription coverage. Contact your local Social Security office and let them know when plan to retire.

Steven Rodriguez Giudicelli · Answer

As you retire and move to Medicare, understand your enrollment periods to avoid penalties and familiarize yourself with Medicare Parts A, B, C, and D. Carefully assess your healthcare needs, including doctors and medications, to choose between Original Medicare with supplemental coverage or a Medicare Advantage plan that best fits your requirements and budget.

Answered by Steven Rodriguez Giudicelli on June 3, 2025

Broker Licensed in FL & TX

Answered by Steven Rodriguez Giudicelli Medicare Insurance Agent

Calvin Fritz · Answer

When transitioning from your employer's health plan to Medicare, consider your eligibility for Medicare Part A and Part B, potential special enrollment periods, COBRA options, and the costs and benefits of Medicare compared to your employer's plan.

Answered by Calvin Fritz on April 8, 2025

Broker Licensed in MO, AL, AR & 22 other states

Answered by Calvin Fritz Medicare Insurance Agent

Lori Crivelli · Answer

If you are medicare eligible age 65 or older, you will need to apply for parts A & B. Once you have your Medicare card you will want to meet with a licensed agent to help you determine the best plan. COBRA coverage is not creditable for Medicare and you could have a penalty if you take COBRA and not enroll in Medicare.

Answered by Lori Crivelli on April 6, 2026

Broker Licensed in CA, AZ, FL & 6 other states

Answered by Lori Crivelli Medicare Insurance Agent

Roseann Vandevender · Answer

Congratulations on your retirement. I want to make sure they understand all of their healthcare rights and options. They will learn about what Medicare covers and doesn’t cover and how we can mitigate these costs.

Answered by Roseann Vandevender on July 21, 2025

Agent Licensed in OH, AZ, CO & TX

Answered by Roseann Vandevender Medicare Insurance Agent

Ken Correa · Answer

Several things should be at the top of your list as you move from your Employer's plan to Medicare. Are you currently on a HMO or PPO plan. Is it of prime consideration for you to keep your doctor(s). Will you be doing a lot of traveling or extended stays away from your home area. Can you match or beat your current deductibles and Maximum Out Of Pocket costs. Do you have any drugs that are very expensive. 

These are just the beginning of going through the in depth process of getting all your questions and concerns answered. If you are with an experienced professional to guide you on this journey there should be other items that come up for your consideration. Always look to see what options are available and how they compare as you make you decision.

Stacy Cogar · Answer

Once you have your retirement date you should contact Social Security to get enrolled into Medicare parts A & B. Once you receive your Medicare# you need to speak to a licensed Medicare agent to discuss your best options for coverage.

Answered by Stacy Cogar on May 6, 2026

Broker Licensed in OH, AL, AR & 32 other states

Answered by Stacy Cogar Medicare Insurance Agent

Adriana De la Cruz · Answer

That's a great question! Moving from employer coverage to Medicare can be a big step. You'll want to think about things like when you need to enroll to avoid any late fees, what parts of Medicare you need, and if you want extra coverage like a Medigap plan or Medicare Advantage. It might sound a little confusing, but don't worry, I can help you through it.

Answered by Adriana De la Cruz on May 23, 2025

Broker Licensed in TX, AZ, CA & NM

Answered by Adriana De la Cruz Medicare Insurance Agent

Rachel Gauthier · Answer

This is a multi-faceted question as there are many things that come into play. Your retirement income, your current health, your current prescriptions, your physicians, and what you want your personal reitrement to look like all play a large part in selecting the appropriate Medicare plan for you. I would reccomend you speak to a licensed insurance agent that specializes with Medicare plans and how all plans are related to your taxable income to assist you in avoiding any potential penalties.

Answered by Rachel Gauthier on September 29, 2025

Agent Licensed in FL

Answered by Rachel Gauthier Medicare Insurance Agent

Mark Mabaquiao · Answer

Basically, here are the things or questions you need to consider when moving to Medicare when retiring (at 65 years old):

(1) Will you enroll in Medicare Parts A and B online at ssa.gov or will you be automatically enrolled because you are currently receiving Social Security benefits?
(2) How do Medicare Parts A, B, C, D, and E work? 
(3) Based on your prescription drugs (if any), medical providers (if any), and medical concerns (if any), which Medicare coverage model gives you better peace of mind - Medicare Advantage or Medigap (plus a drug plan)?
(4) Should you consider adding additional policies like dental / vision / hearing, hospital indemnity, cancer / heart / stroke, short-term care, and long-term care?
(5) Should you consider working with a licensed professional, a SHIP counselor, a Medicare.gov rep, or do all the research on your own.

Megan Day · Answer

First of all, I would see if your employer plan offers any type of pension or retirement benefits. If you are a state employee most likely they will offer a pension or retirement. You should get your Medicare part A and B then go from there with your plan choice.

Answered by Megan Day on September 17, 2025

Agent Licensed in AR

Answered by Megan Day Medicare Insurance Agent

Mark Enright · Answer

Do you like your employer plan? Why do you like it? What does it cost you? Many people don't have a clear idea what their employer plan is costing them. Also, is it important for you to continue with the same doctors and hospitals when you move to Medicare? It's also very important that you have an accurate list of your prescriptions when deciding on a Medicare option.

Answered by Mark Enright on April 23, 2025

Broker Licensed in IL, CO, FL & 6 other states

Answered by Mark Enright Medicare Insurance Agent

Jerry Naylor · Answer

I would review and understand any employee retirement coverage that may be available. Also take the appropriate steps to register for Medicare past A and for part B as necessary. Research your Medicare plans (Supplement or Advantage) to determine which may be best for your individual situation and the timeline (based on your age) to sign-up. If initial age 65 sign-up you have seven (7) months in which to enroll (three (3) months before your birthday, the month of your birthday and three (3) months after your birthday).

Answered by Jerry Naylor on September 29, 2025

Agent Licensed in NC & VA

Answered by Jerry Naylor Medicare Insurance Agent

Lawanda Radford · Answer

Thank you for your question, and congratulations on your upcoming retirement! If you’re leaving an employer health plan, you’ll have a Special Enrollment Period to join Medicare—don’t delay to avoid penalties. Understand the Parts of Medicare: Parts, A, B,C, and D. Need help? Talk to a licensed Medicare advisor to make the transition smooth.

Answered by Lawanda Radford on May 13, 2025

Agent Licensed in GA, AZ, FL & 10 other states

Answered by Lawanda Radford Medicare Insurance Agent

Oscar Molina · Answer

Medicare gives you an eight month window to get on Medicare. Whether it be Original or Advantage after you retire. It is best to consult with Medicare.gov and an agent who can guide you on what type of Medicare coverage is best for you.

Answered by Oscar Molina on March 12, 2026

Agent Licensed in UT, CA, TX & WA

Answered by Oscar Molina Medicare Insurance Agent

Sonia Heredia · Answer

I would suggest that you enroll in Medicare Part A and B before you lose your health insurance through your employer. Then get a Medicare Advantage plan or a Supplement Plan.

Wendy Villarreal · Answer

When you retire and leave your employer’s health plan, it’s important to enroll in Medicare Part A and B so you don’t have any gaps or penalties. You’ll also want to compare Medicare Advantage and Supplement options to see which gives you the best coverage and prescription benefits.

I've been on my employer's health plan but am retiring soon. What should I consider when moving to Medicare?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

I've been on my employer's health plan but am retiring soon. What should I consider when moving to Medicare?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website