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Should you do something about your health insurance? It depends on a few factors.

First, are you employed by a company that has 20 or more employees? If you are offered group insurance that you like you are not required to enroll in Medicare because your employer’s insurance plan will provide primary coverage. If you decide to enroll please be sure to enroll only in Medicare part A, not part B, to avoid potential problems later enrolling in a Medicare supplement plan. You will also be saved the expense of unnecessary part B premiums.

If this first example fits your situation beware of remaining enrolled in a high deductible (H.S.A. eligible) plan. Contributions to H.S.A. accounts are not allowed once you are enrolled in Medicare so you could avoid that problem by not enrolling in Medicare part A. The other problem is that the prescription coverage in a high deductible health plan is not considered creditable and you will face late enrollment penalties when you ultimately sign up for a Medicare part D plan. The penalties are not large, but you should be aware that they exist.

Second, are you employed by a company that has less than 20 employees? If you enroll in the group insurance offered please know that this coverage is secondary to Medicare and requires you to be enrolled in both Medicare parts A and B. The insurance company is responsible for charges not covered by Medicare so if appropriate Medicare coverage is not in place you may find significant gaps in your coverage.

Also, with the new Affordable Care Act rate structure there is no longer a discount in the insurance rate for coordination with Medicare coverage. Rates for those over age 64 will remain at the group’s highest level even though the insurance carrier is responsible for a much smaller set of claims than for those under age 65.

Third, any time from your birthday at age 65 on you are allowed to move to traditional Medicare if you are covered by a creditable group medical plan. This may be worth considering if you are not happy with the benefits of your group insurance plan, the network being used, the premiums being charged or other factors. You will then need to decide whether traditional Medicare (possibly with a Medicare supplement and a Medicare part D plan) makes the most sense or whether a Medicare Advantage plan is the most appropriate.

There are many considerations and many decisions to be made. Make them thoughtfully and know that we at Czajkowski Dumpel & Associates, Inc. are here to help you find the answers you need.