If you’re turning 65 and still have job-based health insurance, you might be weighing your options. Should you stick with your employer’s plan or switch to Medicare?
With Medicare Advantage plans in 2025 offering lower costs, prescription coverage, and extra benefits like dental and vision, many employees are making the switch. However, the right choice depends on your company’s plan, coverage costs, and whether Medicare offers better value.
At Skyline Benefit, an independent group health and Medicare broker, we help individuals and businesses navigate their health coverage options. In this guide, we’ll break down the pros and cons of employer health insurance and Medicare Advantage to help you make the best decision.
How Medicare Works with Employer Health Insurance
Your employer’s health plan determines whether you need Medicare at 65. The key factor is the size of your company:
- If your employer has 20 or more employees – Your job-based insurance is primary, and Medicare is secondary. You can delay enrolling in Medicare Part B without penalties.
- If your employer has fewer than 20 employees – Medicare becomes the primary payer, and your employer plan is secondary. You must enroll in Medicare Part A and Part B to avoid coverage gaps and late penalties.
If you’re unsure how your employer plan coordinates with Medicare, Skyline Benefit can help review your options.
Is Medicare Advantage a Better Choice?
Medicare Advantage (Part C) plans replace Original Medicare (Parts A & B) and often include:
Lower Premiums: Some plans have $0 monthly premiums.
Prescription Drug Coverage: Most plans include Medicare Part D for medications.
Extra Benefits: Dental, vision, hearing, and wellness programs are included.
Out-of-Pocket Cost Limits: Unlike Original Medicare, Medicare Advantage caps annual expenses.
If your employer plan has high deductibles, no prescription coverage, or lacks additional benefits, Medicare Advantage could be a more cost-effective alternative.
When Should You Switch from Employer Insurance to Medicare Advantage?
You may want to consider switching if:
- Your employer health plan has high monthly premiums or high deductibles.
- You need prescription drug coverage not included in your employer plan.
- You want dental, vision, or hearing benefits that Medicare Advantage offers.
- You plan to retire soon and need an affordable, all-in-one health plan.
Before deciding, comparing Medicare costs and benefits with your current plan is important. At Skyline Benefit, we provide expert guidance to help you choose the right coverage.
Need Help Choosing Between Employer Health Insurance and Medicare Advantage?
Skyline Benefit is an independent group health and Medicare broker in Fullerton, CA, we help individuals and businesses navigate their health coverage options.
Selecting the right plan can feel overwhelming, but our mission is to simplify the process and support you every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112