01/15/2026
Are you turning 65 and still working? Here is a break down of how coverage works if you decide to keep your employer based coverage.
Are you turning 65 and covered by an employer health plan based on your active work or your spouses work? If the employer has 20 employees or more, the primary coverage will be the employer health plan and the secondary Will be Medicare. If the employer has less than 20 employees, the primary coverage will be Medicare (you need both A AND B ), and the secondary will be the employer health plan.
Are you on Social Security disability prior to age 65 and covered by an employer health based plan on your active work or your spouses work? ( YOU MUST HAVE MEDICARE PART A IN THIS SITUATION), if the employer has 100 or more employees then the employer based plan is primary and Medicare A (part b is optional) would be secondary. If the employer has less than 100 employees, MEDICARE (will need both A and B in this situation) will be primary and the employer based plan will be secondary.
Will you be covered by COBRA after separating service from your employer or your spouses employer (not based on active work), then any size employer, Medicare (need both A and B ) will be primary, secondary will be COBRA.
Are you 65 and covered by a retiree employer based health plan ( not based on active work), retiree plan coordinates with Medicare and Medicare A and B will be primary, then secondary will be the retiree plan.
If the retiree plan is a Medicare Advantage plan, then the retiree plan will be primary and the secondary is Not applicable in this situation.
Again, as always, if you or anyone you know needs help, call me @ 239-223-4863 Laura Cepero with Cepero Senior Advocates!