Know Your Medicare Options

Find What to Do for Your Situation

Moving to Medicare presents new options for health care coverage, and everyone’s situation is different. Choose the circumstance that currently applies to you:

I have coverage through an employer (or former employer) with 20 or more employees
I have coverage through an employer with fewer than 20 employees
I have coverage through an Individual Exchange plan
I’m on someone else’s health plan

I Have Coverage Through an Employer (or Former Employer) With 20 or More Employees

Choose the appropriate scenario for your coverage:

My Company Offers an Employer-Sponsored Medicare Plan for Retirees
Take these steps as you prepare to enroll in Medicare:

You can delay enrolling in Medicare Part B until you retire. You should have enrolled in Medicare Part A when you turned 65 if you were entitled to premium free coverage.

When you retire, contact the Social Security Administration to enroll in Medicare Parts A and B.

Be sure your employer group plan has “creditable” prescription drug coverage (drug coverage that is as good as Medicare’s standard). If not, you may enroll in a Medicare Part D plan to avoid penalties later.

NOTE: A popular option is to enroll in a Medicare Advantage plan (Part C) that already includes Part D prescription drug coverage. Contact us for more guidance, or contact the Social Security Administration or Medicare. You must have Medicare A and B to enroll in a Medicare Advantage plan.
My Company Doesn’t Offer Coverage to Retirees
Take these steps as you prepare to enroll in Medicare:

If you haven’t already done so, you should enroll in Medicare parts A, B, and D. If you didn’t enroll within three months after your 65th birthday, you may incur penalties.

You should enroll in a Medicare plan on your own once you’ve enrolled in Medicare A and B (if you haven’t already done so).

Remember to cancel your current health care coverage at the same time your Medicare plan starts to avoid duplicate coverage.

NOTE: A popular option is to enroll in a Medicare Advantage plan (Part C) that already includes Part D prescription drug coverage. Contact us for more guidance, or contact the Social Security Administration or Medicare. You must have Medicare A and B to enroll in a Medicare Advantage plan.

I Have Coverage Through an Employer With Fewer Than 20 Employees

Take these steps as you prepare to enroll in Medicare:

If you haven’t already done so, you should enroll in Medicare parts A, B, and D. If you didn’t enroll within three months after your 65th birthday, you may incur penalties.
You should enroll in a Medicare plan on your own once you’ve enrolled in Medicare A and B
(if you haven’t already done so).
Be sure your employer group plan has “creditable” prescription drug coverage (drug coverage that is as good as Medicare’s standard). If not, you may enroll in a Medicare Part D plan to avoid penalties later.

NOTE: A popular option is to enroll in a Medicare Advantage plan (Part C) that already includes Part D prescription drug coverage. Contact us for more guidance, or contact the Social Security Administration or Medicare. You must have Medicare A and B to enroll in a Medicare Advantage plan.

I Have Coverage Through an Individual Exchange Plan

I Want to Continue Paying for My Exchange Plan Rather Than Go on A Medicare Plan Because of Better Benefits

Keep these options in mind as you near retirement:

If you haven’t already done so, you should consider enrolling in Medicare parts A and B. If you didn’t enroll within three months after your 65th birthday, you may incur penalties.
Know that when you become eligible for Part A, you’ll lose any premium tax credits or other savings you currently receive for your Exchange plan.
Be sure your Exchange plan has “creditable” prescription drug coverage (drug coverage that is as good as Medicare’s standard). If not, you may enroll in a Medicare Part D plan to avoid penalties later.

I’m on Someone Else’s Health Plan

Choose the appropriate scenario for your coverage:

The Subscriber/Planholder Will Continue Working Beyond When I Turn Age 65. The Employer Will Allow Me To Remain on The Subscriber’s Plan After Age 65 While the Subscriber Is Still Working, and There Are More Than 20 Employees.
Keep these options in mind as you near retirement:

You can delay enrolling in Medicare Part B until the subscriber retires. You should have already enrolled in Medicare Part A if you are entitled to premium free coverage.

Check to see if your plan has “creditable” prescription drug coverage (drug coverage that is as good as Medicare’s standard). If not, you may enroll in a Medicare Part D plan to avoid penalties later. You must also have Medicare Part A and/or Part B to enroll in Part D.

When the subscriber retires, contact the Social Security Administration to enroll in Medicare Parts A and B.
The Planholder Will Continue Working Beyond When I Turn Age 65, and I Want to Keep the Employer Group Coverage, but the Employer Has Fewer Than 20 Employees.
Keep these options in mind as you near retirement:

You should already have enrolled in Medicare parts A and B. If you didn’t enroll within three months after your 65th birthday, you may incur penalties.

Be sure your Exchange plan has “creditable” prescription drug coverage (drug coverage that is as good as Medicare’s standard). If not, you may enroll in a Medicare Part D plan to avoid penalties later.
The Planholder Will Continue to Work for Their Employer With Fewer Than 20 Employees. But I Want to Terminate My Dependent Coverage and Buy a Medicare Plan on My Own.

Take these steps as you prepare to enroll in Medicare:

The subscriber should inform the employer group that you want to cancel your dependent coverage.

You should contact the Social Security Administration to apply for Medicare parts A and B. If you didn’t enroll within three months after your 65th birthday, you will have to pay a penalty.

You should consider enrolling in a Medicare Advantage or supplemental plan if you want to enhance your Medicare coverage.

You should consider enrolling in a Medicare Part D prescription drug plan to go along with your Medicare Advantage or supplemental plan.

MVP Health Plan, Inc. is an HMO-POS/PPO/HMO D-SNP organization with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in MVP Health Plan depends on contract renewal. MVP Health Plan, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12/31/2024 based on review of MVP Health Plan’s Model of Care. Health benefit plans are issued by MVP Health Plan, Inc., an operating subsidiary of MVP Health Care, Inc. Not all plans available in all states and counties. Every year, Medicare evaluates plans based on a 5-star rating system. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For accommodations of persons with special needs at meetings, call 1-800-324-3899 (TTY 711).

Other physicians/providers are available in the MVP Health Care network. Gia virtual care services are available at no member cost-share for medical plans, including qualified high-deductible health plans (QHDHPs). Exceptions may apply for self-funded plans. In-person visits and referrals are subject to cost-share per plan. Members enrolled in a Medicare Rx plan without additional MVP medical coverage do not have access to MVP virtual care services through Gia. SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers On-Demand is a trademark of Tivity Health, Inc. ©2023 Tivity Health, Inc. All rights reserved. GetSetUp is a third-party provider and is not owned or operated by Tivity Health, Inc. (“Tivity”) or its affiliates. Users must have internet service to access online services. Internet service charges are responsibility of user.

TruHearing® and (RE)TM are trademarks of TruHearing, Inc. All other trademarks, product names, and company names are the property of their respective owners. Retail pricing based on prices for comparable aids. Follow-up provider visits included for one year following hearing aid purchase. Free battery offer is not applicable to the purchase of rechargeable hearing aid models. Three-year warranty includes repairs and one-time loss and damage replacement. Hearing aid repairs and replacements are subject to provider and manufacturer fees. For questions regarding fees, contact a TruHearing hearing consultant.

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Last Updated: 3/1/2024

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