Entrepreneurs and Medicare

Entrepreneurs and 2019 Medicare

We recently received a question from an entrepreneur named Matthew. He told us that he would turn 65 next year and he is trying to decide if he should join Medicare or stay in his company’s health insurance.


This is a very common question that we receive as it is more of a gray area when it comes to what makes the most sense for you.


I would like to make it clearer to you today.


If you’re an entrepreneur and are trying to make your Medicare decision, the first question you’ll want to answer is whether you can keep your business plan.


If you have fewer than 20 employees in your company, you will need to sign up for Medicare. (Note: If you are disabled, it must be 100 people, otherwise you will be signed in to Medicare.)

Another question would be, “If you stay in your business plan, how much does it not only cost you, but how much does it cost you as an entrepreneur?”


As a business owner, your health insurance company should help you understand how the premiums will change next year when you’re 65 years old. This is a crucial factor in deciding what makes the most sense for you.


We had another customer named Benard who turned 65, when he realized that both his individual and company health expenses would rise dramatically if he adhered to the business plan.

To save himself and his company money, we recommended that he join Medicare.


This is not a completely black and white answer, and it ultimately depends on the price of health insurance for you and your company, but also on other factors, including family members, in your company’s health insurance.


Some people finally decide to remain with their employer plan.


Those who are in their occupational health plan, usually


  • Do have other family members on their plan,
  • Do you have extremely low health insurance if they stay on the plan, or
  • Having a juicy income.


Medicare has a rule where people with higher incomes are charged more money to get their cover. Often these fees are so high that they stay better in health insurance.


What is the open registration period for Medicare?


Prescription drug plans (Part D) and Medicare Advantage (Part C) make changes every year – such as coverage, costs, and the providers and pharmacies in their networks. From the 15th of October to the 7th of December, everyone with Medicare can decide to modify their prescription drug coverage and Medicare health plans for the next year to better finance their requirement.


What can I do during AEP?

  • Drop your Medicare prescription drug coverage.
  • You can enroll for Medicare Advantage plan instead of original Medicare.
  • You can also refuse a Medicare Advantage plan and switch back to Original Medicare.
  • End one Medicare Advantage plan while switching to another.
  • Change from a Medicare Advantage plan which do not include drug coverage to a plan that does, and vice versa.
  • Switch to another prescription drug plan from a previous one.
  • Join a Medicare prescription drug plan.