Are There Alternatives to Medicare?

Being Medicare-eligible doesn’t mean it’s necessary to enroll immediately. There are alternatives to Medicare. These alternatives include creditable group coverage through your employer until you retire, TRICARE, Veterans benefits, or Indian Health Services. Medicare Advantage is sometimes considered an alternative option. No matter your choice, we’ll go over what you need to know to make the best decision.

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Is Employer Coverage an Alternative to Medicare?

Since Part A is premium-free for almost everyone, it doesn’t make sense not to enroll when you become eligible. When it comes to Medicare Part B, you can choose to delay enrollment if you have creditable coverage through your employer.

You have the choice to keep your employer’s group health insurance plan if you’re still working when you first become Medicare-eligible. Medicare works with employer health insurance depending on the size of your employer’s company.

If you’re working for a company with 20+ employees, your group coverage is primary. The coordination of benefits determines which plan pays first.

Small business group insurance is for companies with fewer than 20 employees. If you work for a smaller organization – the coverage is not considered credible under Part B, and you could face a Part B penalty for not enrolling.

Make sure to compare both Medicare Supplement plan and Part B premiums with your employer’s deductions from your paycheck. Consider medication costs as well as deductibles and copayments. If Medicare plus Medigap offers lower prices – dropping your employer insurance may make sense.

If you’re covered by your spouse’s plan through their employer, the same rules apply for delaying enrollment and creditable coverage.

Is Medicare Retiree Insurance an Alternative to Medicare?

Sometimes, your employer will continue to offer coverage after you retire. This is called retiree insurance, and it can work as a Supplemental policy alongside Medicare. You can also enroll in retiree insurance on its own, but it won’t cover a spouse or dependents. Retiree insurance is also not creditable coverage, so you’d face penalties later on.

Can I Choose Marketplace Coverage Instead of Medicare?

You can keep insurance purchased through the ACA Marketplace after becoming eligible for Medicare. However, you’ll lose your premium subsidy once you become eligible for premium-free Part A.

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This means you’ll have to pay full price for your health plan, and Medicare is most likely more affordable. Further, plans through the Marketplace don’t have to be as good as Medicare. So, the coverage you receive isn’t creditable. Meaning, you’ll incur penalties if you delay enrollment.

Is Medicare Advantage an Alternative to Medicare?

The main parts of Medicare include Parts A and B. A Medicare Advantage plan, or Medicare Part C, isn’t exactly an alternative for Medicare. Though, it’s often called a replacement plan. Being on an Advantage plan requires you to enroll in Part B. Further, Part C must cover any service that Part A or B covers.

This option is beneficial for some people in certain situations. Examples include those eligible due to a disability. Not all states offer Supplemental options to those under 65. Further, some individuals can’t afford the premiums. Premiums for those under 65 can be as much as 4x more than those over 65.

Another time Advantage may be a good alternative is when the monthly premiums for Medigap are unaffordable for someone whose only retirement income is Social Security.

The primary issue with Advantage plans is the out-of-pocket costs not incurred with Original Medicare. So, even if you have a low premium, you still end up paying more out of pocket than you would have. Be sure to weigh the pros and cons before enrolling in an Advantage plan.

Are There Alternatives to Part D?

Enrolling in Part D isn’t a requirement. Although, if you don’t have adequate drug coverage for more than 63 consecutive days following initial eligibility, you may face a Part D late enrollment penalty. Creditable alternatives for drug coverage are TRICARE, Indian Health Service, the United States Department of Veterans Affairs, and employer group coverage. Many other drug coverage plans are acceptable to use alongside Medicare. However, if you plan on enrolling in a Part D plan in the future, you’ll need to make sure that coverage is at least as good so you can avoid the penalty.

What’s the Best Alternative to Medicare?

Medicare isn’t mandatory, and the best alternative depends on your situation. There may not be an alternative that gives you better coverage than Parts A and B when paired with a Medigap plan. Perhaps your employer coverage is better, or maybe an Advantage plan is a good alternative if other Supplement options are out of your price range. The fact remains that some coverage is better than no coverage.

FAQs

Is there an alternative to Medicare?

Medicare Advantage can handle your claims instead of Medicare, but that doesn’t mean it’s a better option. In most cases, Medigap alongside Medicare is more comprehensive.

What is the best alternative to Part B?

If you’re still working, an employer plan or marketplace plan could be an option. Although, may find that Part B costs less than private health benefits.

Can you choose not to have Medicare?

Medicare isn’t mandatory, so you can choose to opt out. However, if you don’t have creditable coverage during the time you’re eligible for Medicare and you choose to enroll later, you’ll have to pay a lifetime penalty on top of your monthly premium.

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