Individual health insurance
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Some Medicare beneficiaries may have individual health insurance which they bought before becoming eligible for Medicare. For example, if you used up all of your COBRA or CalCOBRA benefits and you are not 65-years-old or eligible for Medicare, and you meet the definition of an eligible individual under HIPAA (Health Insurance Portability and Accountability Act) rules, companies are required to sell you an individual health insurance policy regardless of your health.
Note: Some employers offer conversion coverage of their group health benefits when COBRA coverage ends. If you choose this option you will not be eligible for the guaranteed issue of an individual health insurance policy under HIPAA as described above. You will need to compare both the conversion benefits and an individual health insurance policy to see which better suits your needs.
Individual health insurance and Medicare
You can keep your individual health insurance when you become eligible for Medicare. The insurer cannot cancel your individual policy as long as you continue to pay the premiums. For example, a Medicare beneficiary may keep her/his individual health insurance because it offers better coverage for prescription drugs than a Medicare Part D plan, and/or it has benefits not covered by Medicare.
Yet, not all individual insurance policies will coordinate with Medicare. Read your Evidence of Coverage or Explanation of Benefits from your individual plan to determine how, if at all, your plan will coordinate with Medicare. If you keep an individual plan and it coordinates with Medicare, Medicare will be primary.
Note: If you are eligible for Medicare before age 65 because of a disability, you have another option besides keeping an individual health insurance policy. Medigap companies are required to sell you a Medigap plan for six months after you first sign up for Medicare Part B. These plans, however, are not as comprehensive as most individual health insurance purchased before age 65, and people with permanent kidney failure cannot buy one. The premium you will pay for a Medigap policy depends on the company, the policy you choose, and your age.
See a HICAP counselor to help you weigh your choices. You can also see our section Your rights to purchase a Medigap policy.back to Medicare and other health insurance
Page updated April 29, 2008