If your company has fewer than 20 employees, it’s important to understand how Medicare impacts your group health plan.
Why Medicare Enrollment Matters for Small Groups
To ensure employees have complete coverage for their healthcare needs Sana asks that Medicare-eligible employees in small groups enroll in Medicare when they become eligible.
When an employer has fewer than 20 employees, Medicare becomes the primary payer for individuals age 65 and older, per both Medicare’s coordination of benefits rules and Sana’s policy. Sana then acts as the secondary payer, covering eligible costs not paid by Medicare.
If an eligible employee doesn’t enroll in Medicare, they may not be fully covered—Sana may not be able to pay for services Medicare would normally cover, which can lead to denied claims or unexpected out-of-pocket expenses.
We know this can be a complicated topic, but we’re here to help make it simple for you and your team. Our Support team can walk you through any questions about who needs to enroll and when.
What You and Your Employees Need to Know
To receive the full benefits of the Sana plan, all Medicare-eligible employees must enroll in both Medicare Part A and Part B, unless their eligibility is due to End-Stage Renal Disease (ESRD), in which case different rules apply
If employees have questions about ESRD or aren’t sure when to enroll, they can reach out to Sana Support through their member portal for help.
When to Enroll in Medicare
Turning 65 soon?
Employees have a 7-month window called the Initial Enrollment Period (IEP):
- Starts 3 months before the month they turn 65
- Includes their birthday month
- Ends 3 months after their birthday month
Already 65 and still working at your company?
Employees should enroll now to avoid gaps in coverage or lifelong late penalties.
Missed the Initial Enrollment Period?
They can still enroll during the General Enrollment Period:
- January 1 – March 31
- Coverage starts the month after they enroll
Why This Matters for Employers
When eligible employees enroll in Medicare, everyone benefits:
- Lower claims for your group — because Medicare pays first, Sana pays less
- More sustainable costs — keeping your self-funded plan more affordable over time
- Fewer disruptions — employees avoid denied claims and gaps in coverage
How Employees Can Enroll in Medicare
Eligible employees can sign up through the following channels:
- Online: ssa.gov/medicare
- By Phone: 1-800-772-1213 (Social Security)
- In Person: Local Social Security office (appointments recommended)
Have questions? We've got you covered.
- Log in to view account details.
- Search FAQs in our Help Center.
Connect with Customer Support directly through the chat icon on most Sana pages or call us at (833) 726-2123 Monday through Friday, 7 AM to 7 PM Central.