When you turn 65, a big decision often looms: Medicare Advantage or employer insurance. Which one makes more sense for you?
With 2025 shaping up to be another pivotal year in healthcare, many Americans nearing retirement (or still working) are wondering whether to stick with their employer health plan or make the switch to Medicare Advantage. And it’s not a one-size-fits-all answer.
At Skyline Benefit, we help individuals weigh this decision every day—looking at cost, coverage, flexibility, and long-term impact. Let’s break it down simply so you can make the best choice for your health and wallet.
What’s the Difference Between Medicare Advantage and Employer Insurance?
Medicare Advantage (Part C) plans are all-in-one alternatives to Original Medicare. Offered by private insurers, these plans bundle hospital, medical, and often prescription drug coverage—plus additional benefits such as dental, vision, hearing, and wellness programs.
Employer health insurance varies by company but usually includes group-based medical coverage with shared costs between you and your employer.
So, how do you choose between Medicare Advantage or employer insurance? The right path depends on your work status, company size, medical needs, and financial goals.
Still Working Past 65? Here’s What You Need to Know
If your employer has 20 or more employees, your employer insurance remains primary, and you can delay Medicare Part B and Medicare Advantage without a penalty. This gives you time to compare your options and switch later if it makes sense.
But if your company has fewer than 20 employees, Medicare becomes your primary coverage. In this case, delaying Part B or Medicare Advantage could cost you late penalties and denied claims. You’ll need to enroll on time, even if you’re still working.
Why Many Choose Medicare Advantage in 2025
In today’s healthcare climate, more people are choosing Medicare Advantage over employer insurance because:
- Many plans have $0 premiums
- You get extra benefits not always included in employer plans
- Out-of-pocket costs are capped, which isn’t true for Original Medicare or some employer policies
- You’re no longer tied to one provider network or corporate plan
Whether you’re retiring soon or just weighing options, Medicare Advantage could offer more flexibility—especially if your employer’s plan is expensive or limited.
COBRA Doesn’t Count—Here’s Why That Matters
Planning to stay on COBRA coverage after leaving work? Be careful. COBRA isn’t considered creditable coverage for Medicare. That means you need to enroll in Medicare Advantage or employer insurance (if still active) to avoid penalties.
Once COBRA ends, your window to switch shrinks fast—so talk to an expert before it’s too late.
How to Decide: Medicare Advantage or Employer Insurance?
Here’s a quick guide:
- Do you have a large employer plan that’s affordable and includes dependents? You might want to delay Medicare Advantage.
- Does your employer coverage cost more or lack vision, dental, and hearing? Medicare Advantage could be the better value.
- Are you retiring soon, or have you already left your job? Medicare Advantage likely offers more stability and benefits than COBRA.
Skyline Benefit Helps You Compare—At No Cost
Choosing between Medicare Advantage or employer insurance isn’t just a financial decision—it’s about your care, comfort, and control over your health.
At Skyline Benefit, we’ll walk you through every step:
- Review your current employer coverage.
- Compare Medicare Advantage plans in your zip code.
- Help you enroll without hassle or penalties.
You don’t pay us—the insurance carriers compensate us. That means unbiased support and expert advice, completely free to you.
Need Help Choosing Medicare Advantage or Employer Insurance in 2025?
Skyline Benefit is an independent Medicare insurance broker that offers affordable and flexible Medicare Advantage options.
Whether you’re still working, retiring soon, or just comparing benefits, we’re here to make this easy.
Schedule a consultation today. Call us at: (714) 888-5112.