Will Medicare cover everything my current employer plan does?

Question

Dana Dane · Accepted Answer

In general, most people on Medicare who receive employer health insurance will delay Medicare Part B enrollment. In this case Medicare Part A (in-patient services) is billed first. I would contact your employer health insurance plan to find out what your cost sharing would be for specific services.

Answered by Dana Dane on April 3, 2025

Agent Licensed in OR, AZ, CA & 6 other states

Answered by Dana Dane Medicare Insurance Agent

Tony Capraro III · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/will-medicare-cover-everything-my-current-employer-plan-does#tony-capraro

Charise Karjala · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/will-medicare-cover-everything-my-current-employer-plan-does#charise-karjala

Tasha Riggs · Answer

Generally speaking Medicare tends to cover more benefits than employer coverage. 
Even if your employer pays for your premiums the coverage when you use it , is typically far superior. The network of doctors is very very large.  I

Daniel Maisel · Answer

No, Basic Medicare Parts A & B covers 
A: HOSPITAL
B: DOCTORS. 

No prescription drugs unless administered by a doctor. 

That is why the majority of people on Medicare get:
1) Medicare Supplement or Medi-Gap plan.
Or
2) A Medicare Advantage (Part C) plan. 
3) A Prescription Drug (Part D) plan.

They fill in, when combined with basic MEDICARE usually much mire than the coverage you are getting from your employer.

Of you have any questions, feel free to contact me direct and I can answer more specific questions you may have. 

My assistance is complimentary, their is no fee.

Daniel Maisel Insurance Solutions Medicare Agency 
(909) 319-5324 
CA Lic #0620516. -  NPN #2714786 
Www.InsureItDan.com

Mark Cunningham · Answer

While both Medicare and employer plans provide health coverage, they differ significantly in scope and benefits. Employer plans often offer comprehensive packages that include medical, dental, vision, and sometimes even wellness programs. Medicare, however, primarily focuses on medical and hospital insurance.

Medicare consists of several parts, each covering different aspects of healthcare:
•	Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
•	Part B (Medical Insurance): Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
•	Part C (Medicare Advantage): An alternative to Original Medicare, offered by private companies approved by Medicare. Provides all Part A and Part B benefits and may include extra benefits like vision, hearing, and dental.
•	Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs.

Employer-sponsored health plans typically provide a broader range of coverage options, including:
•	Medical Insurance: Comprehensive coverage for doctor's visits, hospital stays, and medical procedures.
•	Prescription Drug Coverage: Often includes a wider range of medications and lower co-pays.
•	Dental and Vision Insurance: Coverage for routine dental exams, cleanings, vision tests, glasses, and contact lenses.
•	Additional Benefits: Wellness programs, gym memberships, mental health services, and other perks.

While Medicare offers extensive medical and hospital coverage, it may not include all the benefits that an employer-sponsored plan does. Carefully comparing the two can help you determine the best path forward for your healthcare needs.

Michael Caldwell · Answer

No, Medicare will not cover everything your current employer plan does, even if you're eligible for Medicare and still working. Medicare is designed to work with other insurance, and how they interact depends on your employer's size.

Answered by Michael Caldwell on May 20, 2025

Broker Licensed in IN, AL, AR & 31 other states

Answered by Michael Caldwell Medicare Insurance Agent

Steven Bleicher · Answer

If you work for a major corporation, due to their buying power with so many employees being covered for healthcare, it is incumbent upon you to do a comparison study as to which insurance covers more ground: your employer's plan or Medicare? Though, if you work for a smaller company, now it likely becomes more clear that Medicare will be the better choice. The main topics to review are: the # of days covered with an official admittance to a hospital, what the copays are with a visit to specialists or labs, if there is a free gym membership included, what drugs are covered especially those brand name drugs that can afford to advertise on TV, etc., etc.

Answered by Steven Bleicher on May 30, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Timothy Brown · Answer

That depends the on the additional coverage beyond what Original Medicare,(Red, white & blue card) offers. Medicare Advantage/Part C plans can provide coverage similar to employer plans. Medicare Supplements/Medigap plans offered more enhanced medical coverage to Original Medicare Part A & B (Doctors & hospitals) only. Additional coverage for prescription drugs, dental, vision, etc. will require separate plans.

Answered by Timothy Brown on April 8, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent

Leslie Helene Sussman · Answer

Medicare may NOT cover all that your current employer plan does or has in the past. It is a great idea to always compare your current employer Health Plan to your Medicare plan options to find out what plans in your area cover.

Answered by Leslie Helene Sussman on April 7, 2025

Broker Licensed in NJ, FL & PA

Answered by Leslie Helene Sussman Medicare Insurance Agent

Yasmery Vargas · Answer

No. All plans are different. Don't drop employee coverage unless you have problems with it or premium is to high.

Diana Salisbury · Answer

You can not assume that will happen.  An agent or broker will help compare plans to see what type of plan will work best for you.

Chad Watkins · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/will-medicare-cover-everything-my-current-employer-plan-does#chad-watkins

Fred Manas · Answer

No, Medicare will not cover everything your employer plan does. Medicare and employer-based coverage coordinate benefits, with the employer plan usually being the primary payer if you work for a company with 20 or more employees. This means Medicare pays second, after the employer plan has paid its share. Even with both plans, you may still have out-of-pocket costs like deductibles, copayments, or coinsurance. 
Elaboration:
Coordination of Benefits:  When you have both Medicare and employer-based coverage, the plans coordinate their benefits to determine who pays first and second. 
Primary vs. Secondary Payer:  The employer plan is generally the primary payer if you work for a company with 20 or more employees, meaning it pays first. Medicare becomes the secondary payer, covering any remaining costs for covered services. 
Employer-Based Coverage as Primary:  If you work for a company with 19 or fewer employees, Medicare typically pays first, and the employer plan is the secondary payer. 
Out-of-Pocket Costs:  Even with both plans, you may still have out-of-pocket costs like deductibles, copayments, or coinsurance. 
Medicare Coverage:  Medicare covers most medically necessary services and supplies in hospitals, doctors' offices, and other healthcare facilities. However, it doesn't cover everything, such as routine physical exams, eye exams, and most dental care. 
Employer Plan Benefits: Employer-based plans often offer benefits beyond what Medicare covers, such as prescription drug coverage, dental care, and vision care. 
Importance of Coordination of Benefits:  Understanding how Medicare and your employer plan coordinate benefits is important for ensuring that you receive the most appropriate coverage and minimize out-of-pocket costs.

Gary Henderson · Answer

If you get a Medicare supplement plan, it'll cover more than that by a long shot. Covers 100% hospitalization and 100% outside the hospital. After you meet your annual deductible which for 2025 is $257, you'll need to purchase a separate prescription drug plan, but if you just take generic medications, there's a plan from WellCare that is often $0 per month 
Medicare supplement plans are your best option 
It also you can go any doctor. You're not locked into any particular Network like you are today with your employer plan. Any doctor takes Medicare will take your Medicare supplement plan by law
Medicare advantage plans are not your best option and are similar to your employer plans, but they have high Max out of pocket annually which the negative part of it

Glenn Alterman · Answer

Please send me your summary of benefits and I will locate an MAPD  plan matching your work benefits. Original Medicare will not have dental and vision visits, gym memberships etc

Barbara Barnes, CMIP® · Answer

No. Medicare will cover medically-necessary health services, but that will not include dental, vision, hearing and prescription drugs that may be covered by your plan at work. Medicare is a very different form of health coverage than employer-provided group plans. Before moving into a Medicare plan, you need to understand the various parts of Medicare and the difference between Original Medicare and Medicare Advantage.

Answered by Barbara Barnes, CMIP® on April 3, 2025

Agent Licensed in PA

Answered by Barbara Barnes, CMIP® Medicare Insurance Agent

Mike Sosso · Answer

This is a great question because if you have qualified employer coverage from an empoyer of 20 or more employees, don't have to enroll in Medicare A&B when you first turn 65 if you are planning to keep your employer coverage. Otherwise you could face a penalty if you don't enroll at that time.  But when you have qualified employer coverage you don't have to enroll until you lose that coverage. 

For this reason we always recommend a detailed review of employer coverage to include the costs associated with that coverage and compare it with what Medicare would provide.  In many cases, Medicare offers more and better coverage for less money.  If that is the case, we would recommend staying with the employer coverage until you plan to retire.  

A personal evaluation for each situation is always avisable so you or someone you know is facing this situation, have them reach out to us and we can review your situation for no cost or obligation.

Stephen Ashford · Answer

It depends on what kind of coverage your employer's plan includes. Medicare Part A covers hospitalization costs, and Part B covers doctor visits. You will need to in a Part D to cover prescriptions and get some kind of supplemental coverage for Dental, Vision, and Hearing. Most people I work with choose to get Part C which are Medicare Advantage plans. They usually cover prescriptions, dental, vision, hearing and provide other benefits (grocery cards, social security give backs, transportation).

Answered by Stephen Ashford on May 2, 2025

Broker Licensed in NY, AR, IA & 5 other states

Answered by Stephen Ashford Medicare Insurance Agent

Will Medicare cover everything my current employer plan does?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

Will Medicare cover everything my current employer plan does?

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