For self-funded employers, even one high-cost claimant can represent six-figure annual spend. If MediMatch helps accelerate Medicare enrollment for just a handful of Medicare-eligible employees each year, the claims avoidance can easily exceed the cost of the platform many times over.
MediMatch is an offboarding optimization tool, not just a Medicare lead system. By helping Medicare-eligible employees transition off the group plan faster—whether they're retiring or continuing to work past 65—you reduce claims exposure and improve plan performance.
The Employer Impact (Illustrative)
How Claims Avoidance Works
When Medicare-eligible employees stay on the group plan—whether by inertia, lack of education, or choosing COBRA—they continue to generate claims. For self-funded employers, a single high-cost claimant (cancer treatment, major surgery, chronic condition management) can cost $100,000 to $500,000+ annually.
If MediMatch accelerates Medicare transitions and prevents or shortens even one high-cost claim, the ROI is immediate.
Common Scenarios
Scenario 1: The "Almost Retired" Employee
- Employee turns 65 but delays retirement by 6–12 months
- Issue: They remain on the group plan during this time, generating claims
- MediMatch Solution: HR directs them to text MediMatch to explore Medicare options now, so they're ready to transition immediately upon retirement—or even before, if eligible
Result: Months of claims avoidance, especially valuable if the employee has chronic conditions or ongoing treatments.
Scenario 2: The Working-Past-65 Employee
- Employee continues working past 65, staying on the group plan
- Issue: Without guidance, they may not know they can switch to Medicare even while still working (depending on employer size and plan rules)
- MediMatch Solution: MediMatch educates them on Medicare eligibility and coordinates the transition—removing them from the group plan sooner
Result: Reduced claims exposure for an aging population, often with higher utilization.
Scenario 3: The COBRA Enrollee
- Employee retires at 64, elects COBRA, then turns 65 mid-COBRA period
- Issue: Many don't realize they can drop COBRA and move to Medicare immediately at 65—they stay on COBRA for the full 18 months
- MediMatch Solution: Proactive outreach educates them on Medicare eligibility at 65, shortening their COBRA stay
Result: Months of COBRA claims eliminated—especially important for self-funded plans where COBRA claims still hit the employer's bottom line.
Why This Matters for Self-Funded Employers
A single $200K+ claim can wipe out months of cost containment efforts. Moving Medicare-eligible employees off the plan faster reduces this exposure.
Lower claims ratios mean better renewals, more predictable budgets, and stronger negotiating positions with stop-loss carriers.
Most employers rely on employees to figure out Medicare on their own. MediMatch makes offboarding an active strategy, not a passive hope.
Employees get clear Medicare guidance and support—improving their experience while benefiting the employer's bottom line.
MediMatch documents offboarding steps, ensuring proper procedures are followed and reducing compliance risk.
The Bottom Line
MediMatch isn't about generating Medicare leads—it's about protecting your self-funded employer clients from avoidable claims. When Medicare-eligible employees transition faster, claims exposure drops, plan performance improves, and renewals become more favorable.
For many employers, the ROI calculation is simple: if MediMatch helps move 2–3 employees off the plan each year and prevents even one high-cost claim, it pays for itself many times over.
That's why we position MediMatch as an offboarding optimization tool—because claims avoidance is the real value, and Medicare transitions are the mechanism. Brokers who lead with this messaging differentiate themselves as strategic partners, not just policy vendors.