‘No wonder the American public is confused.’ If you’re working at 65, should you get Medicare or keep your employer plan?

You have reached the Medicare qualifying age of 65. But what if you are still working and have employer-sponsored insurance? What should you do?

Unfortunately, there is no easy answer. For the average person, understanding how your variables can affect what you purchase is confusing and challenging without expert help. There are, however, a range of options that didn’t exist for our parents.

Take Mark L. Clark of Mooresville, North Carolina. He retired early as a human resource professional four years ago. He carried health insurance for his wife, Cindy, a market research contractor without benefits. Mark has a part-time job that offers benefits, but his employer’s health insurance is expensive.

Catastrophic coverage, to start

At his retirement from full-time work, the couple sought a marketplace plan to cover catastrophic care they could fund without an employer subsidy. They found one for $950 monthly, with a $10,000 deductible.

Two years ago, the couple learned they qualified for a government subsidy even with income from their investments and part-time work. The subsidy brought their premium costs down by two-thirds.

Three months before he turned 65, Clark started talking with an agent about his Medicare options.

“A Medicare Advantage (MA) plan sounded like it would be a good option for me because I’m not having any health issues,” he said. However, after hearing acquaintances express coverage and financial concerns about their MA plan, “at the last minute, I decided to go with original Medicare, a supplement, and a Part D drug card,” Clark said. He takes no medication; his drug card costs $11 a month.

Cindy, 64, is still on the marketplace plan; her rates doubled when he left the plan.

Clark mentioned that in the months before he turned 65, their mailbox would fill up with brochures about Medicare Advantage plans. “No wonder the American public is confused,” he said. He added that before he started the process, he “believed that when you go on Medicare, the government takes care of all healthcare needs.”

Of course, it doesn’t, but that is a common misconception. In fact, patients also have skin in the game.

An abundance of choices

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