How can a company pay an individual's Medicare Part B premium?

Question

Hi. I have a very specific and obscure question. I am interested in how a company, a health plan for instance, could go about paying an individual's Medicare Part B premium. Does anyone know where the rules governing this are housed?

Answer 1

This is a good question! A local organization was considering implementing a policy whereby it would pay the insurance premiums for Medicare-eligible employees about a year ago and did some checking through attorneys. The rules discovered were that a private employer that offers a health care plan to employees must offer the same plan to all employees-- even those eligible for Medicare. There was no way found for the employer to pay the Medicare premiums for the employees eligible to enroll in Medicare.

I understood that the reason this could not be done was due to a state rule--but actually, the barrier is probably a federal rule. Allowing this practice would increase costs to Medicare and probably reduce the costs of employer health insurance plans. Congress probably is concerned enough about soaring Medicare costs. Of course, there is probably a plethora of other political reasons...

Some feel this rule engenders employers' discrimination against older workers. The fact is, more health problems develop the older we get and the American workforce is aging quickly. Paying for health insurance is a big problem for most employers--and especially small business. Many choose not to provide a health insurance plan at all due to these plans' costs--which is a major reason why there are so many uninsured Americans today.

Suggestion: check with someone in your State's Insurance Commissioner's office. There is someone there who might be very familiar with this question--or would know someone else who would have the information you seek. Or check with an attorney familiar with health insurance and employment law in your state.

Good luck and best wishes!

Answer 2

Actually, if a person WANTS to leave his/ her group plan because the options under Medicare it is their choice. The rule states that if the company has 20 or more employees, it must allow those over 65 to remain in the plan. Under the Small Employer Exception: If an employer, having fewer than 20 full and/or part-time employees, sponsors or contributes to a single-employer Group Health Plan, the Medicare Secondary Payer rules applicable to individuals entitled to Medicare on the basis of age do not apply to such individuals. There are cases in which going on Medicare with a Medicare supplement plan may be better than their employer offered plan where, let's say... , their deductible is $5,000 and they have more out of pocket remaining in the form of co insurance. With Medicare and their supplement, they could have little to no out of pocket and therefore be worth switching. The Employer in return may benefit from the older person leaving the group health plan through a significant decrease in the entire plan's premiums. If the employer values the employee and wants to offer his Medicare insurance they can not pay for the premiums unless they are an owner, spouse of an owner or a retired worker. So usually, it is common for them offer an increase in their salary to offset the difference in their insurance premiums. Whatever the Medicare Beneficiary feels is right for them is the best choice. I recommend contacting a licensed Insurance Agent to determine a comparison of your group plan to Medicare.


http://www.suntimes.com/business/savage/18833130-452/65-year-olds-at-small-employers-may-be-forced-to-use-medicare.html


Under the Small Employer Exception: If an employer, having fewer than 20 full and/or part-time employees, sponsors or contributes to a single-employer GHP, the MSP rules applicable to individuals entitled to Medicare on the basis of age do not apply to such individuals.

The rules state that if the company has 20 or more employees, it must allow those over 65 to remain in the plan. But with fewer than 20 employees, the company could require that you enroll in Medicare Part A, the free portion of Medicare, during the initial enrollment period. Then the company plan would become a secondary provider. However the company can also drop you from its plan altogether under the Small Employer Exemption. Source: 65-year-olds at small employers may be forced to use Medicare
http://www.suntimes.com/business/savage/18833130-452/65-year-olds-at-small-employers-may-be-forced-to-use-medicare.html

Answer 3

you should call Medicare in case you do not wany any section D plan. in the different case, Medicare assigns one to you shut to the position you stay. you could call Medicare and ask those questions.