Should I switch to Medicare or Should I stay with the insurance I currently have in San Diego?

Medicare is an incredible health insurance offering that you should absolutely take advantage of. It is our recommendation that you switch to Medicare as soon as you turn 65 years old. As a United States citizen you have been contributing money towards your Medicare policy for your entire working life. Now is your chance to take advantage of this government-sponsored Medicare health insurance plan. The plan premiums, deductibles, and out of pocket costs are all going to be a much better deal for you the consumer when you switch to Medicare. There are almost no examples of a non-Medicare plan that is better than the San Diego Medicare offerings.

 

Medicare is fantastic. It is much better than all of the other San Diego health insurance offering you have. So let's take a look at your current situation and why it is going to be better for you to switch to Medicare.

Should I stick with my current Individual Health Insurance policy or switch to Medicare?

You can get individual health insurance plans from the California Health Exchange called Covered California. You can also get an individual plan if you contact the insurance carrier directly and sign up with them. However, these plans are very expensive and get more expensive as you get older. The plans monthly premiums are age based meaning the older you get the more expensive they are.


For example, let's assume you want access to Scripps Doctors in North County. The best option on the individual market for a 64 year old is to select the Silver HMO Trio plan from Blue Shield. This plan premium is $931.84 per month! With this plan you have a $4000 deductible! 

Now let's compare that to Original Medicare with a Supplement plan N here in San Diego. For most people, Original Medicare Parts A + B cost $144.60 per month. We can then add $111.68 per month to join plan N, one of the best Supplement plans here in San Diego for 2020. For a total of $256.28 per month, you now have a deductible of $198. Clearly, you'll want to switch to medicare from your Individual plan.

Although the individual health insurance market has some solid silver and gold plans that will help you in your time of need, there is no question in my mind that not a single plan on the individual health experience exchange through Covered California is close to the benefits that you will receive from a Medicare Plan.

Should I stick with my group health insurance policy or should I switch to Medicare?

Perhaps you are not enrolled in a plan through the individual exchange but instead you are enrolled with a plan through your company. Similar to individual plans, group health insurance policies for businesses with 100 employees or fewer are also age based. When you approach your 65th birthday your group health insurance policy plan will be very expensive.

The major difference between an individual policy and one through your company is that your employer is required to contribute some money to cover your monthly costs. By law, your company is required to pay for 50% of your health insurance premiums each month. Even after calculating the costs, 50% of a plan through your employer is more expensive than 100% of a medicare plan.

It is also nice to keep in mind how much money you can help your company save when you switch to Medicare. Employers are excited to help employees move to Medicare because they appreciate not paying so much each month for your insurance.

I personally sell group health insurance policies here in San Diego and I can confidently say that a plan through Medicare, with either a supplement plan or an advantage plan, is going to be better than what you are receiving from your business.

However, some companies are extremely generous with their health insurance offering and it can make it difficult to switch over to Medicare. For example, I work with a company in Carlsbad that pays 100% of the employees health insurance costs and 80% of the family's costs. This is an unbelievably generous offer. Even in this scenario, it was worth it to evaluate the newly 65 year old's Medicare options. Both the employer and employee agreed that moving to Medicare was best.

Should I stick with my Large Group Employer health insurance policy or should I switch to Medicare?

For companies larger than 100 employees, health insurance policies are no longer age based. The group takes the entire age of the company, averages it out, and provides the same rate for all employees no matter their age. 

 

Even though you at age 65 will get a better deal than someone at age 30, these group health insurance plans still do not match the price or quality of care you can receive from a 2020 Medicare Supplement plan.

For example. I have a family member approaching her 65th birthday. She has awesome insurance through her employer Nordstrom. Her company pays half the monthly plan costs meaning she only pays $230 a month. This is extremely inexpensive considering a similar plan on the age based market would cost $800 or more.

Here is the kicker. The plan is not as good as a Supplement Plan from Medicare. Currently, her deductible through work is $2500. A great Supplement plan like Plan N or Plan G has a deductible of $198. All in with Original Medicare and the Supplement Plan N here in San Diego, she's looking at $256.28 a month and a much better plan with almost no deductible. So for a few extra dollars a month, she can reduce her $2500 deductible to $198, have a more robust and encompassing plan, and visit any network of doctors and hospitals in San Diego.

In short, you should move from your Large Group Employer plan to a Medicare plan as soon as you turn 65.

Should I still switch to Medicare even if my family is covered by my insurance plan?

Yes! The savings you receive by switching to medicare is significant. So significant that it is still worth the switch to Medicare even if your family is covered by your current plan. Pairing your entire family into a single health insurance plan offers a handful of benefits. You'll all share a "family deductible" which can help save some out of pocket costs during an unhealthy year. However, pairing your entire family into a single plan does not save you money on monthly premiums.

The best thing to do is enroll yourself in a medicare plan and enroll your family members in their own plan. You'll save money each month with your new, less expensive, Medicare plan and your family will be able to continue coverage through their individual plan.

One scenario that may be difficult to evaluate is when you are eligible for Medicare but your employer is covering the costs for both your family members premiums and your own premiums. Our HealthyMarks team is excellent at evaluating these two options and figuring out the best course of action for you. We can calculate how much money you would save by switching to Medicare and how much money are you sacrificing by giving up your employer's contribution towards your dependent's plans. If you employer contributes a lot, you'll likely want to stay with that employers plan cause they are spoiling you and your family. In a majority of cases, employers only offer a small amount of money to cover dependents plan costs. In fact most businesses do not cover dependents at all because they are not required to.

 

It is a very easy process to enroll your family members on a great individual plan. Our health insurance team is able to help you move to Medicare and move your family to an individual plan. Give us a call today so we can share with you the best path forward so you can save hundreds of dollars each month by moving to a San Diego Medicare plan.

Should I still switch if my awesome health insurance is better than what's available through Medicare?

Every once in a while I will come across an employee who does have awesome health insurance coverage, even better than what's available through Medicare. This means they are paying less than $300 a month in premiums, they have a deductible less than $200, and they are able to see the doctors they want to see. This is rare but amazing.

Our Medicare Office Team is the best at evaluating your current plan and whether or not it is better for you to switch or stay. If you are enrolled in a plan better than what is offered through Medicare, you will want to know if you are subject to any late enrollment penalties. If you do not enroll in Original Medicare at the age of 65, you may end up paying more for it in the future due to late enrollment fees. However, you can avoid all penalties if you are receiving your health insurance from your employer. Our team is great at helping you avoid those penalties so you can stay with your awesome insurance.

 

In these cases I like to discuss the process of moving to Medicare WHEN the right time comes. Our team is able to make sure you do not incur any penalties by not enrolling in Medicare. We'd love to help you evaluate your plan options and navigate the enrollment process.

To learn more, visit HealthyMarks.com

© 2020 by HealthyMarks Insurance Services

Keaton Marks License #0L47187

760-484-0979    -    San Diego

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