Following our Aug. 20, 2022 article What is a Medicare Secondary Payer, more questions were asked about your options when you turn 65. Below is a great overview of how this works.
Baby boomers are turning 65 and are adding an average of 10,000 new Medicare beneficiaries every day since 2018. In addition, there are more working adults over the age of 65 than there have been since Medicare was created in 1965, but then came the Great Retirement, along with some new Medicare beneficiaries. From commercial to Medicare. Others hold commercial spousal coverage and are covered under this plan. This means that there are insurance options for those over the age of 65. Let’s take a look at some options as we create a spreadsheet to complete the comparison below.
Decision points and related research to aid in decision making.
People are also reading…
Employed: Continue the insurance plan provided by your employer.
What is the monthly premium? What are the service deductibles and copayments? Medication benefits – what are you paying for generic drug options? What are the maximum out-of-pocket costs?
Stop your employer-sponsored plan and transition to traditional Medicare.
What is the monthly premium for traditional Medicare? Part B/Outpatient, Part D/Drugs, and optional supplemental insurance covering deductibles and co-payments for services? Part A/Inpatient Hospital and What is your out-of-pocket cost for using all outpatient services/Part B without additional charges? You must include your own personal health and usage history to create an estimate. How much do you pay for prescription drugs? MyMedicare.gov has a free booklet, “Medicare and You,” which provides an excellent overview of the services and resources included in Traditional Medicare.
Stop your employer-sponsored plan and move to Medicare Advantage/Part C.
Costs differ from traditional Medicare, but include plan-specific Part D (prescription drugs) monthly premiums included in Part C monthly premiums, along with Part B (physician visits, outpatient clinics, and durable (covering medical devices) will continue to exist. All Medicare Advantage plans have their own coverage package and monthly premium.
Note: If you decide to continue your employer-provided plan, you can still add Medicare Part A to your employer-provided plan for free. Medicare is a “secondary payer” because you are still working and your employer insurance plan has a primary employer-sponsored plan. When you retire, Medicare becomes your primary, even if you have retirement insurance benefits from your employer.
Summary: Review your Medicare options according to your current employer-sponsored insurance plan’s monthly premiums, deductibles, co-payments, and current health conditions. All Medicare plans have drug coverage “tiers,” so pay close attention to drug benefits in your employer’s plan. Drugs that are usually expensive can have significantly higher out-of-pocket costs. Also, after her initial period of turning 65, there is an annual enrollment period so you can re-evaluate what works best for you each year.
Do a “happy dance” when you turn 65 and consider your insurance options. Yes!
Day Egusquiza is President and Founder of Patient Financial Navigator Foundation Inc., an Idaho-based family foundation. For more information, call 208-423-9036 or visit pfnfinc.com. Have a Health Care Buzz topic? Share it at daylee1@mindspring.com.
.
