Healthcare Educators


Can You Have Private Insurance and Medicare?

by | Sep 6, 2019

When you turn 65, you age into Medicare. For many people, this is fantastic news. Others, however, may have other coverage that they want to keep. This raises the question – can you have private insurance AND Medicare? In some cases, this is possible.

Job-Based or Retiree Coverage and Medicare

If you have access to a job-based group health plan, and if the employer has at least 20 employees, it’s possibly to delay enrollment in Medicare without facing late penalties. However, enrollment in COBRA or retiree health plan does not exempt you from late penalties.

Some people may decide to enroll in Medicare to avoid late fees while maintaining enrollment in a COBRA or retiree plan. This is sometimes possible, but it’s important to understand how the two plans interact. For example, Medicare will typically be the first payer, and the retiree health plan will be the second payer. Additionally, having Medicare may impact your eligibility for retiree coverage. For more information, watch this video on retiree insurance.

The Marketplace and Medicare

Many people who don’t have job-based coverage turn to the Health Insurance Marketplace for their health and dental insurance. However, people who have Medicare coverage are not eligible to use the Marketplace to purchase a health plan or a dental plan.

You cannot have both Medicare and a Marketplace plan.

Additionally, delaying enrollment in Medicare can result in late penalties. These penalties can be very costly, and they can last for as long as you have coverage. For this reason, it’s important to enroll in Medicare on time.

However, in some cases, you may be able to enroll in a Marketplace plan instead of Medicare. This can happen, for example, if you would have to pay for Medicare Part A and decide not to participate in Medicare as a result. See the page on Medicare and the Marketplace for more details.

Other Plans and Medicare

It may be possible to combine Medicare coverage with other plans. In some cases, this may be done to obtain additional benefits or to cut down on out-of-pocket costs.

Original Medicare does not cover everything that beneficiaries might need. For example, it does not cover dental or vision benefits. Many Medicare Advantage plans offer these additional benefits, which is one reason these plans have become so popular in recent years. However, people enrolled in Original Medicare, as well as people enrolled in Medicare Advantage plans that do not offer these additional benefits, will have to look elsewhere for dental and vision coverage. Some people may choose a standalone vision or dental plan in addition to Medicare.

Need Medicare guidance? PTT Financial agents can help. Contact us to learn more.