Comparing Group Insurance & Medicare When You’re Turning 65

epiainsurance
1 day ago
2 min read

Turning 65 is a major milestone — and it often comes with big questions about health insurance. If you’re still working or covered through your employer, you might wonder:

👉 Should I stay on my company plan, or switch to Medicare?

👉 What happens if I do both?

👉 Could I save money by changing?

At EPIA Insurance Agency Inc., we help you make sense of it all. Here’s what to consider when comparing Group Health Insurance and Medicare as you approach 65.

Understanding the Basics

Group Insurance is coverage offered through your employer or your spouse’s employer.
Medicare is the federal health insurance program for people aged 65 and older, or under 65 with certain disabilities.

Both offer valuable coverage, but the cost, network, and benefits can differ greatly depending on your situation.

When to Enroll in Medicare

Most people become eligible for Medicare at age 65 and can enroll starting three months before their birthday month.However, if you’re still working and have employer coverage, you might be able to delay Part B (Medical Insurance) without penalty — as long as your employer plan qualifies as creditable coverage.

Tip: If your employer has 20 or more employees, you can usually keep your group plan and enroll in Medicare later without penalty.

Comparing Costs & Coverage

Category	Group Insurance	Medicare
Premiums	Typically shared between you and employer	You pay Medicare premiums (Parts B & D), but often lower overall cost
Networks	Limited to your employer’s network	Broad national coverage — no network restrictions with Original Medicare
Prescription Drugs	Included or optional via employer plan	Covered under Part D (or included in Advantage plans)
Out-of-Pocket Costs	Vary by employer plan	Predictable with supplemental (Medigap) or Advantage plan
Flexibility	Tied to employer plan terms	You choose any Medicare-approved plan that fits your needs

When Medicare Might Be a Better Fit

Switching to Medicare could make sense if:

Your employer plan premiums are high.
You don’t need dependent coverage.
You travel or live in multiple states (Medicare offers wider coverage).
You want more control over your doctors and plan choices.

Conversely, staying on your employer plan may be best if your company offers excellent benefits at low cost — or if your spouse/dependents rely on that plan.

Avoiding Common Mistakes

⚠️ Don’t miss your enrollment window. If your employer plan isn’t creditable, you could face late enrollment penalties for Medicare Part B or Part D.

⚠️ Don’t assume one size fits all. Every company plan is different — and what’s best for your coworker may not be right for you.

At EPIA, we review both your group benefits and Medicare options side by side, so you can make a confident, informed choice.

The Bottom Line

Turning 65 doesn’t mean you have to make the decision alone.Let EPIA Insurance Agency Inc. help you compare your current group coverage with Medicare — including costs, benefits, and long-term value — so you can choose the best protection for your next chapter.

📞 +1 626-912-1988 📧 info@epiagroup.com 🌐 www.epiagroup.com

🔗 Sources:

Medicare.gov – Working Past 65
CMS – Creditable Coverage Rules
Covered California – Transitioning to Medicare