8 Things Baby Boomers Need to Know About Medicare

Turning 65 is a milestone event for anybody. Most members of the baby boomer generation assumed they’d be retired by that age, but more and more, that isn’t the case. Whether retired or not, boomers need to determine how Medicare is going to supplement or replace their health insurance coverage after they reach 65 so they can adjust for and to it.

U.S. Bureau of Labor Statistics data shows that 52 percent more folks are working beyond their sixty-fifth birthday than there were ten years ago. Recognizing this trend, more corporations are trying to integrate Medicare into their coverage options. Each company seems to have their own way of dealing with the trend and how it impacts company-provided health insurance coverage.

To that end, each employee needs to discover the coverage their employer offers at age 65. With some government and civil service jobs, free health care insurance continues from the date of retirement until death. Many companies also contribute to or pay their retirees’ health care premiums in full. Kaiser Family Foundation says that percentage dropped to 28 percent in 2010 from 40 percent in 1995. In some instances, the employee is covered mostly by Medicare. Other folks are covered primarily by their employer. Further complicating the issue are family members.

Here are some points you’ll need to consider to keep your health care coverage in force and adequate. The goal is to blend the two types of coverage, Medicare and employer-provided, into the most effective insurance strategy.

8 Things You Need to Know about Medicare

1.  If you’re employed past 65, will your employer provide insurance? That Group Health Plan (GHP) you’ve been on for so many years may not want you when you’re eligible for Medicare. They can drop you from their plan or significantly lower coverage. If this is the case, your employer might provide supplemental insurance to fill in the gaps if you get private primary Medicare coverage.

2.  If your GHP includes more than 20 people, Medicare is the secondary payer and the GHP is the primary provider. In this case, choosing which Medicare coverage you want to keep is important. There are two parts to Medicare—one is free and one has monthly premiums. Part A covers hospital visits and costs nothing. Part B covers medical services and is optional. Everybody should take Part A. Part B is only necessary if your GHP isn’t adequate. All you need is a referral from Medicare to suspend payments to Part B.

3.  In cases where the GHP is less than 20 people, Medicare assumes the primary role and the employer becomes secondary. In that instance, you need to sign up for Parts A and B. Don’t assume anything. Unless you sign up, you’re not covered. That means you have to pay for any medical services you receive. But before you can make any decisions, you need to get a written statement detailing the coverage provided by your GHP.

4.  If your spouse has medical coverage, it might be better to switch to that policy. By the same token, you have to examine the way the policy meshes with Medicare to make the best choice.

5.  If you’re retired but working a new job, you might have or be able to get retiree benefits from your previous employer. That would permit you to cut costs by dropping Part B Medicare coverage. It might also work better if Medicare is the primary payer and the company plan is secondary. Compare the two options to see which works best for you.

6.  If you have Veteran’s benefits, you may not require Medicare. The Veterans Affairs (VA) services aren’t as flexible as Medicare is. Additionally, all VA treatment must be provided at a VA hospital. You may want to blend the two so you have the option for private care.

7.  How will your decision affect your dependents’ coverage? If your children or spouse will lose coverage when you switch to Medicare at age 65, you might want to consider other options. In some cases, COBRA will cover dependent children. Recent changes allow children to be covered by their parents’ policy. However, they and the rest of your family might need to secure separate coverage.

8.  There are other Medicare options as well. Part C is called Medicare Advantage. This combines Part A and Part B into an HMO. Part D is for prescription drug coverage. Medigap covers care received that isn’t covered by normal Parts A and B. All four types plus Medigap need to be checked to determine their suitability. There are literally dozens of possible options.

[box type=”note”]As you can see, the entire issue can get very confusing. However, if you get a firm understanding of the coverage you have and the coverage you have available to you through the various parts of Medicare, you’ll make a wise decision. The time you spend researching your options will pay off in lower premiums and coverage that is more closely suited to your needs.[/box]



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One thought on “8 Things Baby Boomers Need to Know About Medicare

  • December 7, 2011 at 11:58 am

    In my recent divorce settlement, the children are all covered, I am going to pay for my own coverage however. Thank you for this information, you are so loving to take care of these things, I dont know how to thank you being apart but I have only imagined! Thank you for blessing me!


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