Do you need help to decide if you should stay on your group insurance at work when you start Medicare (at age 65) or when you retire?
This is a very common discussion that we have with our prospective customers when they are trying to decide what is the best option when they have Medicare and they also have Group insurance at work.
One of the first things to understand is that when you turn a 65 even if you’re still working you will get Part A of Medicare automatically. It’s free – there’s nothing that you have to do to get Part A of Medicare.
When you get Part B of Medicare is an option. You may need to get Part B of Medicare when you turn age 65. If you do need to get Part B of Medicare and you are already receiving Social Security benefits you will automatically be enrolled in Part B of Medicare.
One of the first important pieces of information that you will need to find out from your employer is when you turn 65 and you are eligible for Medicare if you’re going to be required to get Part B of Medicare.
If your group plan has told you that they will continue to be your primary insurance at age 65, you may not be required to get Part B of Medicare. However if your group insurance at work tells you at age 65 that they will continue to provide coverage for you but then they want to be secondary to Medicare you most likely will need to get Part B of Medicare.
This is an important thing to know because there is a cost associated with Part B of Medicare. The cost is probably going to be somewhere around $134 a month. This number could change depending on your income, but if you don’t have to pay for Part B of Medicare and you still have some good insurance at work then that is possibly an option that you might choose.
When you turn age 65, if you’re still working, or if you are older than 65 but still have access to group insurance at your past place of employment through your retirement benefits, the decision then becomes should you keep your group plan or should you get some private insurance in the open marketplace.
This is a difficult decision as there many different factors to consider. It’s difficult to compare group policy benefits to the benefits that you will receive on an individual policy, but some of the things that you want to take into consideration are going to be questions such as:
What is the monthly cost going to be for you to participate in the group plan? What will your monthly premium be on your health policy through your group when you turn 65 or when you stop working?
In addition to your monthly cost, do you have any deductible that you have to meet first before your group health plan will pay benefits?
In addition to your monthly premium and your deductible, do you have co-payments for visits to your doctor or visits to a specialist?
Also on a group plan, you want to know if there are any restrictions to where you can receive care. Is their a network? Is there a group or a list of doctors that you have to agree to receive care from? This can be a very important consideration. You also want to understand on your group policy how are your prescription medications covered.
You can see that there can be many different variables that come into play when you are trying to decide to stay on a group plan or to leave a group policy and get an individual plan. Another situation we run across sometimes is that the employee that we are working with has turned 65. They would probably be better off on their own to get an individual Medicare Supplement Plan or some other health insurance plan other than their group plan, but because their spouse is not age 65 yet, the main employee, the primary employee, has to stay on the group plan so that their spouse has some reasonable affordable option for healthcare. This is another important consideration.
If it is determined that it may not be in your best interest to stay on your group plan, the good news is that there are a number of other very good options that you can choose.
Option number one would be to leave your group policy and have Medicare as your only coverage. To have Medicare only. This is not something that we recommend, but it is an option.
The next option would be to get a Medicare Advantage policy. A Medicare Advantage policy is a network plan that does have a lot of co-payments and that has a strict network. It also has a possibly large maximum out-of-pocket cost built into it. This is also not a plan that we don’t recommend, but it is an option.
If you have decided that you’re going to leave your group policy, our recommendation is that you consider getting a Medicare supplement health insurance policy as a secondary to your Medicare. Medicare would be your main coverage. Your Medicare supplement would be your secondary plan.
Between Medicare and your Medicare supplement working together all or most of your doctor and hospital bills will be covered completely. You won’t have any large deductibles. You won’t have any strict networks and you will have very limited and very predictable maximum out-of-pocket costs.
We can talk to you about the different companies that we sell for and the different Medicare supplement plans that are available in your area. We can also talk to you about all the options and all of the steps that you have to take and all the decisions that you have to make when you’re turning 65 or retiring.
We can help you if you are considering staying on your group plan. If you’re considering getting Part B of Medicare. If you’re considering getting a Medicare supplement and also possibly help with choosing and enrolling in a Part D prescription drug. Please give us a call at your convenience.
Billy Williams
800-499-1942
MedicareHealthInsuranceOptions.com
