Retiree health coverage and Medicare

Published by Medicare Made Clear®


When you think of health coverage after retirement, you probably think of Medicare. But some people may also have access to retiree health coverage. So, what is retiree health coverage and how does it work with Medicare?

Retiree health coverage is health insurance that some employers, unions and trusts may offer to retiring employees and their spouses. Typically, it is group health insurance similar to plans offered to active employees. Eligibility, enrollment, coverage and other rules are specific to each employer’s retiree plan.

Do I need Medicare if I have retiree health coverage?

Even if you have a retiree health plan, you most likely need to sign up for Medicare. Depending on the plan, you may need to sign up for Part A and Part B, or just Part A (you must be eligible for Part B). Retiree health coverage might not pay some medical costs during any period in which you were eligible for Medicare but didn’t enroll.

For people who retire before they are eligible for Medicare, retiree health coverage may serve to span the gap between employer health coverage and Medicare. When Medicare eligibility begins, the retiree plan or the coverage may change.

How does retiree health coverage work with Medicare?

Retiree health coverage may help cover some of the costs that Medicare doesn’t. It may also help cover some services that Medicare doesn’t cover.

Some retiree plans are Medicare Advantage plans. These plans provide all the same coverage as Original Medicare (Parts A & B) and often additional benefits and features such as prescription drug coverage and dental, vision and hearing care.

For prescription drug coverage, it’s important to know whether your plan provides creditable drug coverage. If it doesn’t, find out what your options are. Medicare Part D has a late enrollment penalty if you don’t have creditable drug coverage for more than 63 days.

Now that you have a quick overview of Medicare and retiree health coverage, click below to learn more about Medicare eligibility.

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