While today, life expectancy is longer than ever before, there are still many Medicare enrollees who are retired – and because of this, a large number of Medicare participants are not only covered through Medicare benefits, but also through a group health plan (retiree) coverage via a former employer.
In this case, because you essentially have two forms of insurance, you need to understand which of the coverage will pay a claim first, and how each of the plans will coordinate with one another.
Typically, for those who are enrolled in health insurance coverage through a former employer, Medicare will pay on claims first. Then, should there still be a remaining balance once Medicare’s payments have been reached, the group health insurance plan will pay second.
The actual terms and conditions of how the payments will be made will depend upon the group plan itself. Therefore, it is a good idea to become familiar with your plan and the way in which it pays its claims, as well as with how long you are eligible for its benefits.
Each retiree insurance policy is going to have different limits, which means Medicare’s responsibility is going to be different when working with various plans.
What You Should Know About Your Retiree Healthcare Coverage
If you’ve been part of an employer sponsored health insurance plan and you’re ready to retire, there are some things you need to find out about your plan if you intend to keep your coverage. These include:
- Determining whether – as well as for how long – you can continue on the employer sponsored plan after you retire. Because employers are not required to offer retiree coverage, they can potentially alter the benefits and the premiums – and they can even cancel your coverage altogether.
- If you are eligible to remain on the employer plan, finding out the benefits and the premium you will be charged for them. If you are married, you will also need to find out if coverage will also be included for your spouse. In some cases, spousal coverage may be limited.
- Finding out what happens to your benefits when you become eligible for Medicare. Some employer sponsored plans require participants to sign up for Medicare Parts A and B in order to maintain full benefits from the retiree health insurance benefit plan.
- Obtaining information on how your retiree benefits and your Medicare benefits will be coordinated. This can be accomplished by obtaining a copy of your retiree health plan’s summary plan description or the plan benefit booklet, as well as by speaking with your benefit plan administrator.
- Determining what will happen if your employer goes out of business or ceases the health insurance plan in some other way. If so, you could be eligible for COBRA benefits, however, these plans can oftentimes be costly. Therefore, it is important to factor in all potential alternatives.
You may also want to compare the benefits that are offered through your retiree benefits plan and one of the Medicare Supplement insurance plans. In some cases, one may be better than the other in covering your specific healthcare needs.
Because every retiree health insurance plan is different, they will all have different coverage limits and benefits. Some are much better than others, which is why it’s important for every Medicare enrollee to sit down and look at all of their health care coverage options. As we mentioned even if you do have a retiree insurance plan, you should still look at the different Medigap plans.
If you recently enrolled in Medicare, or are about to enroll into the program, it’ s important to look at Medicare supplemental plans that can give you additional coverage that isn’t offered through Medicare or retiree insurance. You can get these through a private insurance company or an agent who sells health insurance. Normally, this is what a lot of seniors look to when they need to fill in the coverage holes.
Each of the plans available, ten of them, offer coverage for things like Medicare Part B excess charges. Some of them cover portions of certain expenses, while others will pay for 100% of them. If you find that these policies give you more coverage than your retiree plan, you’ll have to pick the one that fits your goals. Consider your health, money, and family history before choosing a plan.
You should note that these policies are standardized across the United States, which means that regardless of the company where you purchase the Medigap policy, it is going to have the same coverage as that plan from a different company.
Because the coverage is the same from every insurance company, the only difference is going to be what you pay for the coverage. You can see why it’s important that you can compare several different quotes from multiple insurance companies before you pick the one you want. Don’t waste your time chasing down agents from each individual company, let one of our agents, who is contracted with all of them, do the grunt work for you. Simply enter your zip code on the quote form on the side and all of the best supplemental insurance policies are sent to you.
If you have any questions about your retiree health insurance, Medicare coverage, Supplemental plans, or how any of them will work together, please feel free to contact us today. Having quality insurance coverage is one of the most important things that you can do for yourself, but it can be a confusing process, let us help. We can ensure that you have the coverage that you deserve.