I’m about to turn 65 soon and become eligible for Medicare. I retired a few years ago, and I have very good health coverage through my retiree insurance. Do I need Medicare?
-- Elaine (Spokane, WA)
Dear Elaine,
Yes, in most cases you will need to enroll in Medicare Part A and Part B, so that you have full insurance coverage. Even if your retiree insurance, insurance you get from a past job, paid for most of your health care costs in the past, it typically changes once you qualify for Medicare. Medicare will pay first for health care services you’ve received, and your retiree coverage will pay second.
If you are retired and you do not sign up for Medicare Part A and Part B when you first become eligible, it could be as if you have no insurance at all. This is because retiree insurance typically only pays after Medicare pays. If Medicare does not pay first on health care claims, the retiree plan may refuse to pay any of your health care costs. Moreover, if you wait to sign up for Medicare, you may need to pay a late penalty and wait several months before your coverage will start.
If you’re satisfied with your retiree coverage, you may keep it and have it act as secondary insurance, once you have Medicare. Depending on your benefits, your retiree plan can pay all or some of the leftover health care costs, after Medicare has paid. Your retiree plan may also cover services that Medicare does not cover, such as vision or dental care. Since each retiree plan is different, contact your plan’s benefits administrator to find out about your plan’s costs and the benefits it covers.
In addition, you might be able to get creditable drug coverage through your retiree insurance. Creditable drug coverage is when the drug coverage offered by your retiree insurance is considered as good or better than Medicare Part D coverage. If your retiree insurance offers creditable prescription drug coverage and covers all or most of the medications you’re taking, you may be able to keep your retiree drug coverage and delay enrollment into a Medicare prescription drug plan (Part D).
Of course, there are always exceptions to Medicare coverage rules. If you believe your retiree coverage is an exception to the rule, call the Medicare Coordination of Benefits contractor at 800-999-1118 to find out how your retiree insurance will work with Medicare. You can also call the human resources department or benefits manager of the company through which you have retiree coverage to find out exactly what your retiree insurance covers and how it works with Medicare. See this list of frequently asked questions for more information on Medicare and retiree benefits.
Keep in mind that Medicare might work differently with insurance from a current employer. Call Social Security to see how your employer insurance will work with Medicare. You can also check out Medicare Interactive to learn more about employer insurance and whether you should enroll in Medicare.
Lastly, I’d recommend following the Medicare Rights Center’s checklist of things to do when you’re deciding whether to take or turn down Part B. Remember to call Social Security at 800-772-1213 if you ever need to turn down Medicare. You should not turn down Medicare Part B without confirming that you have primary insurance coverage from another source.
Yes, in most cases you will need to enroll in Medicare Part A and Part B, so that you have full insurance coverage. Even if your retiree insurance, insurance you get from a past job, paid for most of your health care costs in the past, it typically changes once you qualify for Medicare. Medicare will pay first for health care services you’ve received, and your retiree coverage will pay second.
If you are retired and you do not sign up for Medicare Part A and Part B when you first become eligible, it could be as if you have no insurance at all. This is because retiree insurance typically only pays after Medicare pays. If Medicare does not pay first on health care claims, the retiree plan may refuse to pay any of your health care costs. Moreover, if you wait to sign up for Medicare, you may need to pay a late penalty and wait several months before your coverage will start.
If you’re satisfied with your retiree coverage, you may keep it and have it act as secondary insurance, once you have Medicare. Depending on your benefits, your retiree plan can pay all or some of the leftover health care costs, after Medicare has paid. Your retiree plan may also cover services that Medicare does not cover, such as vision or dental care. Since each retiree plan is different, contact your plan’s benefits administrator to find out about your plan’s costs and the benefits it covers.
In addition, you might be able to get creditable drug coverage through your retiree insurance. Creditable drug coverage is when the drug coverage offered by your retiree insurance is considered as good or better than Medicare Part D coverage. If your retiree insurance offers creditable prescription drug coverage and covers all or most of the medications you’re taking, you may be able to keep your retiree drug coverage and delay enrollment into a Medicare prescription drug plan (Part D).
Of course, there are always exceptions to Medicare coverage rules. If you believe your retiree coverage is an exception to the rule, call the Medicare Coordination of Benefits contractor at 800-999-1118 to find out how your retiree insurance will work with Medicare. You can also call the human resources department or benefits manager of the company through which you have retiree coverage to find out exactly what your retiree insurance covers and how it works with Medicare. See this list of frequently asked questions for more information on Medicare and retiree benefits.
Keep in mind that Medicare might work differently with insurance from a current employer. Call Social Security to see how your employer insurance will work with Medicare. You can also check out Medicare Interactive to learn more about employer insurance and whether you should enroll in Medicare.
Lastly, I’d recommend following the Medicare Rights Center’s checklist of things to do when you’re deciding whether to take or turn down Part B. Remember to call Social Security at 800-772-1213 if you ever need to turn down Medicare. You should not turn down Medicare Part B without confirming that you have primary insurance coverage from another source.
—Marci
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