A “Group Health Plan” (GHP) is health insurance offered by an employer, union or association to its members while they are still working. GHP coverage is based on current employment. Employers with 20 or more employees are required by law to offer current workers and their spouses who are age 65 (or older) the same GHP health benefits that are provided to younger employees.
Examples of health insurance policies that are GHPs based on current employment.
- Small or large employer-sponsored plans for its current employees,
- Self-insured plans,
- Employee organizational plans (i.e., union plans or hours banks),
- National health plans in foreign countries.
- Do not include:
- Plans that only cover self-employed individuals,
- Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage,
- Retiree coverage,
- Continued coverage based on severance pay,
- Health savings accounts,
- Veterans Affairs (VA) coverage.
If your GHP is based on current employment, you may not need Medicare Part B when you turn 65. You may get a “Special Enrollment Period” (SEP) to sign up for Part B later without a penalty after the employment or group health plan coverage ends. If you qualify, you can sign up for Part B anytime while you’re covered by an employer or union group health plan (GHP) based on current employment, or you can enroll in Medicare Part B anytime within 8 months after the employment ends or the GHP coverage ends (whichever happens first).
If you would like to learn more, there is additional information on our "Special Enrollment Period" page.
- What if I have health care protection from other plans?
- Will I get Medicare if I live outside the United States?
If you are not sure how to answer these questions and you would like to learn more, read our “Medicare” booklet or talk to your personnel office.