Step-by-Step: How to Switch From Employer Insurance to Medicare

There are many reasons why switching from employer-provided insurance to Medicare could be a smart move for you. Whether it be due to retirement, cost savings, better coverage, employer requirements, or anything in-between—securing your finances and health for the future.

If you’re looking for a step-by-step guide for how to switch from employer insurance to Medicare, you’re in the right place.

What Happens to My Health Insurance When I Turn 65? Before you worry about how to switch from employer insurance to Medicare, it’s important to know if you will need to make the switch in the first place. There are a few scenarios to consider when it comes to your healthcare options after the age of 65:

If you plan to continue working after 65:

You may be able to keep your employer insurance plan If your company has fewer than 20 employees, Medicare will typically become your primary insurance at 65, even if you’re still working. If your company has more than 20 employees, your employer plan generally remains primary until you retire—however, it can be supplemented with Medicare nonetheless. You can keep your employer plan and delay Medicare Part B (with credible coverage) If you retire :

Your employer coverage will typically end—unless your employer offers retiree health coverage—and you will need to enroll in Medicare. Always check with your HR department or benefits administrator to confirm how your coverage will coordinate with Medicare, or if you are required to enroll once you turn 65.

Medicare Basics When Leaving Job-Based Insurance Before you take the step to switch from employer insurance to Medicare, it’s vital to understand the breakdowns of different Medicare plan options.

There are several different components of Medicare, referred to as “parts”. These consist of the types of coverage you require, and the parts you choose to enroll in will vary depending on your needs:

Medicare Part A is essentially hospital insurance —this covers things like inpatient hospital stays, skilled nursing facility care, hospice care. Medicare Part B is akin to traditional medical insurance . It covers things like preventive medicine, outpatient care, visits to the doctor’s office, and medical supplies. Medicare Part D is a prescription drug plan that can be added onto Medicare Parts A, B, or C, and covers prescription medications. Medicare Part C is also known as Medicare Advantage . It is a combination of Medicare Part A, B, and often D. Medigap , also known as Medicare Supplement , is a series of optional plans that help pay some out-of-pocket costs not covered by Original Medicare. Pro Tip : When you hear the term “Original Medicare”, this refers to Medicare Parts A and B.

Compare Medicare Plans

When to Apply for Medicare: Enrollment Periods to Know Similar to understanding the different parts of Medicare, it’s equally as important to know the enrollment period you’ll be qualifying for. This helps you avoid late penalties and gaps in coverage.

If you are switching over from employer-provided insurance to Medicare, the enrollment periods that most likely apply to you are the Initial Enrollment Period (for those aging into Medicare or retiring) or the Special Enrollment Period (for those who have lost healthcare coverage through their employer).

How Do I Switch Over to Medicare? Here’s the step-by-step guide for how to switch from employer health insurance to Medicare:

Step 1: Confirm Your Employer’s Benefits Structure If you’re not retiring at 65, speak with your employer’s HR department or benefits administrator to confirm whether enrolling in Medicare is the right next step for you.

Step 2: Gather Your Documents & Information Many websites, like Healthpilot, use this information to compare Medicare plans and recommend the optimal solution based on your needs. Be sure to have the following documentation on hand:

Your employer-provided insurance end date Pay stubs or tax return documents (to serve as proof of employer coverage) Your Social Security number and Medicare eligibility number Your zip code The names of any prescription drugs you take or plan to take in the future Your preferred pharmacies and their addresses Your current doctors (both Primary Care Providers and specialists) Step 3: Enroll in Medicare Part B When transitioning away from employer-provided coverage, you qualify for Medicare enrollment under the Special Enrollment Period (SEP). It is recommended to enroll in Medicare Part B before adding any additional coverage to your plan—many Medicare plan finder tools also require a Medicare Part B number to compare plans and offer recommendations.

You can enroll in only Medicare Part B online through the Social Security Administration website.

Step 4: Use a Medicare Plan Finder Tool Switching from employer insurance to Medicare can feel like a daunting task—and Healthpilot exists to help. We are a free-to-use Medicare plan comparison platform that lets you learn, shop, and enroll all in one place. Plus, our team of compassionate Licensed Medicare Agents are here to support you every step of the way.

Simply enter your health information, and we’ll handle the heavy lifting. Healthpilot compares plan costs, provider networks, pharmacies, preventive services, specialist care, and so much more—and gives you an informed recommendation on the best plan for your needs.

Plus, after you enroll, we continue to act as your Medicare assistant. Should you have any questions, need to file an appeal, or need to review your coverage, we’re just a phone call away.

Get Started With Healthpilot

Step 5: Notify Your Employer & Cancel Your Coverage Once you’re enrolled in Medicare, notify your employer of the change and navigate cancelling your employer-provided coverage.

If you are planning on remaining on employer-provided coverage, Medicare can supplement it. This means the primary insurance (whether it be Medicare or your employer’s) will pay their portion of any medical expenses first, and the secondary insurance will pay the remainder of eligible expenses. Be sure to connect with the right parties at your company to establish a primary and secondary payer.

The main goal with this step is to avoid any coverage gaps and penalties by coordinating the last effective date of one insurance policy and the start date of Medicare, or establishing a primary and secondary payer should you choose to supplement your coverage with Medicare.

Tips to Avoid Medicare Coverage Gaps & Penalties Document your employer coverage end date and keep letters or written documentation that you receive from your employer’s HR department Part D drug coverage has a late enrollment penalty—don’t delay enrolling if this is something you will require Be sure that you know your employer policy for health insurance after turning 65 Use a platform like Healthpilot to compare plan costs, provider networks, and benefits before you switch How Do I Terminate Marketplace Health Insurance? If you have a plan through a marketplace like Healthcare.gov , contact the marketplace directly and cancel coverage before Medicare coverage begins. We recommend setting your marketplace coverage end date for the day before Medicare coverage begins.

Healthpilot: Helping You Transition to Medicare Easily Switching to Medicare can feel overwhelming—that’s why Healthpilot was created. We exist as a support and guidance tool for all things Medicare, whether you’re enrolling for the first time, reviewing your coverage, or need highly accurate comparisons and recommendations based on cost and coverage.

Personalized Plan Recommendations: Recommendations are based on your preferred doctors, location, prescriptions, and preferences. Payer-Agnostic Advice: We show plans from many highly rated carriers, not just one. Ongoing Support: We help you review and adjust coverage yearly. Fast & Easy Enrollment: Complete the process online in minutes. Ready to experience the difference of fully-supported Medicare enrollment? Get started with Healthpilot today .

Switching to Medicare From Employer Insurance FAQs Can I drop my employer insurance and go on Medicare? Yes. At 65 or when you retire, you can switch—just be sure to check your employer plan size and coverage rules.

How do I terminate exchange health insurance when I go to Medicare? Contact the Marketplace and cancel your coverage. To avoid coverage gaps, it’s recommended to set your coverage cancellation date for the day before Medicare starts.

What happens to my employer’s health insurance when I turn 65? If you plan to continue working and your company has more than 20 employees, you may be able to keep your employer coverage or supplement it with Medicare. If you plan to keep working and your company has fewer than 20 employees, you will likely be required to switch to Medicare. If you are planning to retire, you will need to enroll in Medicare, unless your employer offers a retiree health coverage plan. How do I switch over to Medicare? Once you gather all of the necessary documents, use Healthpilot to compare plans and receive a recommendation for the best Medicare Advantage or Medical Supplement option for your needs, and enroll right from our website. Then, contact your employer and inform them of the change.

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