What services does MyMedicareMike.com offer?

We help individuals understand, compare, and enroll in Medicare plans. Our team provides personalized guidance on Medicare Advantage, Medicare Supplement (Medigap), and Prescription Drug Plans so you can make informed decisions with confidence.

Do you charge for Medicare consultations?

No, our services are completely free to you. As licensed and independent Medicare advisors, we’re compensated by the insurance carriers, not our clients.

What’s the difference between Medicare Advantage and Medicare Supplement Plans?

Medicare Advantage (Part C) replaces your Original Medicare and often includes extras like dental or vision. Medicare Supplement (Medigap) works with Original Medicare to help cover out-of-pocket costs such as copays and deductibles.

Can you help me review my current Medicare plan?

Absolutely. We provide free annual plan reviews to ensure your coverage still fits your healthcare needs and budget, since plans and costs can change each year.

When can I enroll or make changes to my Medicare plan?

The Annual Enrollment Period runs from October 15 to December 7 each year. During this time you can switch, drop, or enroll in new Medicare plans. Special Enrollment Periods may apply after certain life events.

Do you represent specific insurance companies?

No. We’re an independent agency and work with multiple top-rated carriers to find the plan that best fits your needs.

Can you assist if I’m turning 65 soon and new to Medicare?

Yes. We specialize in helping first-time enrollees understand their options, avoid penalties, and get started with the right coverage before their 65th birthday.

Do you offer in-person or virtual appointments?

We offer both. You can schedule a face-to-face meeting at our New York office or connect virtually from anywhere for the same personalized guidance.

What if I’m on Medicaid or have other health coverage?

We can help you coordinate your Medicare benefits with existing coverage—including Medicaid or employer plans—so you maintain important benefits and avoid gaps.

How can I get started with MyMedicareMike.com?

Call us or fill out the contact form on our website to schedule a free consultation. We’ll walk you through your options and help you choose coverage that gives you peace of mind.

What If My Employer Has Fewer Than 20 Employees At 65?

What Are People Asking?

● Does employer size really affect Medicare rules?
● Will Medicare become my primary insurance at 65?
● Can I delay Part B if my company is small?
● Will I face penalties if I rely only on my employer plan?

Key Takeaways

● Employer size under 20 employees changes how Medicare works
● Medicare may become the primary payer at age 65
● Delaying Part B incorrectly can lead to penalties and coverage gaps
● Small employer coverage does NOT always replace Medicare

Did You Know Small Employers Follow Different Medicare Rules?

Many people assume that if they are still working, they can safely delay Medicare.
That is NOT always true.
If your employer has fewer than 20 employees, Medicare may become your primary insurance at age 65 — even if you stay on your job’s health plan.

Primary Payer Rule: Why Employer Size Matters So Much

This is one of the most important (and most misunderstood) Medicare rules.
● 20+ Employees → Employer Plan is usually primary
● Fewer Than 20 Employees → Medicare is typically primary
If Medicare is supposed to be primary and you do not enroll, your employer plan may pay less — or not as expected.

What Happens If You Delay Part B With a Small Employer?

Here is where real problems can occur.
If Medicare should have been primary and you delay Part B:
● Claims may not be paid correctly
● You could face unexpected medical bills
● Coverage gaps may occur
● Late enrollment penalties may apply
This is NOT the same situation as someone working for a large employer.

Did You Know You Could Still Face A Part B Penalty?

If you delay Part B without qualifying employer coverage from a large employer, a late enrollment penalty may apply.
That penalty:
● Is added to your monthly premium
● Can last for life
● Increases the longer you delay
This is why confirming employer size before age 65 is critical.

What About Prescription Drug (Part D) Penalties?

Small employer plans do not automatically guarantee creditable drug coverage.
If your prescription coverage is NOT considered creditable:
● A Part D late enrollment penalty may apply
● The penalty can follow you long-term
Always request a “creditable coverage” notice from your employer plan.

Still Working Does NOT Always Mean You Can Delay Medicare

This is a major misconception.
The real question is NOT: “Am I still working?”
The real question is: “Is my employer coverage from a company with 20+ employees and considered creditable?”
Without that protection, delaying Medicare can be risky.

Real-World Scenario (Very Common)

A person turns 65, keeps their small employer plan, and skips Part B.
Later they discover:
● Medicare should have been primary
● Claims were only partially paid
● They must wait for a future enrollment period
● A penalty is added when they finally enroll
This situation happens more often than people realize.

How This Fits Into Your Age 65 Timeline

● 9–10 Months Before 65: Confirm employer size and coverage details
● 6–8 Months Before 65: Verify creditable drug coverage
● 3 Months Before 65: Decide whether Part B enrollment is necessary
Small employer coverage should always trigger an earlier review.

Q & A: Small Employer Coverage and Medicare

Can I rely on my small employer insurance instead of Medicare?

Not always. Medicare may become the primary payer at 65.

Will I be penalized if I delay Part B with a small employer?

Possibly, especially if Medicare should have been primary.

Does employer size really make that big of a difference?

Yes. It directly affects primary payer rules and penalty risk.

What is the safest step before turning 65?

Confirm employer size, creditable coverage status, and how your plan coordinates with Medicare.

A Direct, Practical Takeaway

If your employer has fewer than 20 employees, Medicare may become your primary coverage at age 65 — even if you are still working.
Delaying Medicare without understanding this rule can lead to penalties, coverage gaps, and unexpected costs.
When it comes to small employer plans, assuming you can delay Medicare is one of the most expensive mistakes people make.

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:

Original Medicare (Parts A & B): Allows you to see any doctor or
hospital that accepts Medicare but does not include prescription drug
coverage (Part D) or additional benefits.
Medicare Advantage (Part C): Offers bundled coverage with
potential extra benefits but may require using a network of providers.
Medigap (Medicare Supplement Insurance): Helps cover
out-of-pocket costs not covered by Original Medicare, such as
copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:

Initial Enrollment Period (IEP): A seven-month window starting
three months before your 65th birthday month.
General Enrollment Period (GEP): From January 1 to March 31
each year for those who missed their IEP.
Annual Election Period (AEP): From October 15 to December 7,
allowing you to switch or enroll in Medicare Advantage and Part D
plans.
Open Enrollment Period(OEP): From January 1 to March 31 for
those who missed AEP and want to make certain changes.
Special Enrollment Period(SEP): Can be used anytime during the
calendar year for those that meet certain criteria such as moving to a
new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.

By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.

Do I have to sign up for Medicare?

It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.

Does Medicare cover Prescription Medications?

No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.

I want to be able to go to any doctor/hospital, are there networks with Medicare?

There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.

Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.

Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.