MEDICAL INSURANCE OPTIONS IN RETIREMENT Presented By Kurt - PowerPoint PPT Presentation

MEDICAL INSURANCE OPTIONS IN RETIREMENT Presented By Kurt Swardenski, RHU, REBC Advantage Benefits Group

AGENDA ¡ Under Age 65 Options (Pre-65) ¡ Age 65 and Older Options (Post- 65) Party Time! ¡ Q&A, Examples throughout

PRE-65 RETIREE MEDICAL OPTIONS – PRE 65 1. COBRA continuation coverage 2. Individual Coverage 3. Marketplace Coverage

PRE-65 RETIREE MEDICAL OPTIONS 1. COBRA CONTINUATION COVERAGE COBRA (rates below reflect costs from 7/1/2018 through 6/30/2019) Up to 18 months or until entitled to Medicare, whichever is less Medical/Prescription Drugs PPO 2 MESSA Choices Saver ¡ Single: $591.87 ¡ Single: $615.02 ¡ 2-Person: $1,225.16 ¡ 2-Person: $1,383.80 ¡ Family: $1,497.43 ¡ Family: $1,722.05 § Vision § Dental

PRE-65 RETIREE MEDICAL OPTIONS 2. INDIVIDUAL OPTIONS Individual Plan ¡ Number of carriers: ¡ Priority Health ¡ Blue Cross Blue Shield ¡ Physicians Health Plan ¡ McLaren Health Plan ¡ Cost varies based on smoker status, age, zip code and plan design

PRE-65 RETIREE MEDICAL OPTIONS Instructions to navigate the www.healthcare.gov site: 3. MARKETPLACE PLAN 1) Click “See Topics” from the top ribbon on the homepage Marketplace Plan (www.healthcare.gov) 2) Click “See plans and prices” ¡ Advance Premium Credits (subsidies) based on household income and age ¡ Metal Tier Plans – Platinum, Gold, Silver, Bronze Special Enrollment Period: You may qualify for a special enrollment period if you leave a job where you had health coverage (ie. Retirement) Average monthly cost (age 62, non-smoker, zip: 48859, effective 1/1/19) § Silver Plan for Single: $1124 (9 plans available) - $400 after subsidy Bronze Plan for Single: $820 (7 plans available) - $102 after subsidy ¡ Both plans have a subsidy of $724 per month based on single ¡ household income of $36,000 For Plan and Cost Estimates outside of Open Enrollment, go to: www.healthsherpa.com

PRE-65 WILL I QUALIFY FOR LOWER COSTS ON MONTHLY PREMIUMS? – MARKETPLACE PLAN Estimated 2019 Household Income – based on number of people in your household *NOTE: Eligibility does vary based on age of Savings Programs you may applicant. qualify for: 1 2 3 4 5 6 Free or low-cost coverage through Below Below Below Below Below Below Medicaid based on income alone $16,753 $22,714 $28,676 $34,638 $40,599 $46,561 A Marketplace health plan with lower monthly premiums plus $16,753 - $22,714 - $28,676 - $34,638 - $40,599 - $46,561 - savings on out of pocket costs, like $30,350 $41,150 $51,950 $62,750 $73,550 $84,350 deductibles and copayments A Marketplace health plan with $30,350 - $41,150 - $51,950 - $62,750 - $73,550 - $84,350 - lower monthly premiums $48,560 $65,840 $83,120 $100,400 $117,680 $134,960 You won’t qualify for savings on a Marketplace insurance plan. You can Above Above Above Above Above Above buy insurance through the $48,560 $65,840 $83,120 $100,400 $117,680 $134,960 7 Marketplace at full price, or buy from other sources

PRE-65 WHAT DOES AN AVERAGE (SILVER) PLAN COST? COSTS APPLY FOR INDIVIDUAL OR MARKETPLACE (IF ELIGIBLE FOR SUBSIDY, IT WILL REDUCE PREMIUM) Blue Cross Preferred HMO Silver Extra ¡ Individual Premium (age 62, zip 48859) = $1,126 per month ¡ $4,000 Single Deductible, $7,900 Out of Pocket Maximum ¡ $30 copay after deductible for Primary Care visits. Specialist $65 after deductible ¡ $15 Generic Drugs After Deductible ¡ 20% member coinsurance after deductible for most other services ¡ McLaren Silver Exchange - HMO ¡ Individual Premium (age 62, zip 48859) = $1,107 per month ¡ $3,700 Single Deductible, $7,900 Out of Pocket Maximum ¡ $30 copay for Primary Care visits. Specialist $65 copay ¡ $15 Generic Drugs ¡ 20% member coinsurance after deductible for most other services ¡

POST - 65 RETIREE MEDICAL OPTIONS – POST 65 ¡ 1. Medicare Part A, B and D ¡ 2. Medicare Advantage Plan ¡ 3. Medicare Supplemental Plan

POST - 65 RETIREE MEDICAL OPTIONS - MEDICARE Who runs the Medicare Program? ¡ The Centers for Medicare & Medicaid Services (CMS) is the Federal agency that ¡ runs Medicare. CMS is part of the U.S. Department of Health and Human Services You enroll in Medicare through the Social Security Department ¡ ¡ https://www.ssa.gov/benefits/medicare/ Resource sites: ¡ ¡ http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm ¡ www.medicare.gov ¡ www.medicarerights.org – detailed timeline ¡ www.kff.org – Kaiser Family Foundation ¡ www.medicare.gov/sites/default/files/2018-09/10050-medicare-and-you.pdf ¡ http://offers.priorityhealth.com/medicarefordummies

POST - 65 MEDICARE Part A: Hospital Coverage Part B: Medical Coverage Part D: Prescription Drug Insurance Part C (Advantage Plan): Combines Part A, B and D into one package Medigap (Supplemental Plan): Secondary to Traditional Medicare

POST - 65 MEDICARE COVERAGE CHOICES Step 1: Decide how you want to get your coverage START Medicare Advantage Plan Original Medicare (like an HMO or PPO) Part B (Medical Part A (Hospital Coverage) Coverage) Part C (Includes BOTH Part A (Hospital Insurance) and Step 2: Decide if you want to add drug coverage Part B (Medical Insurance) and usually Part D Part D (Prescription Drug Insurance) Part D (Prescription Drug Insurance) Step 3: Decide if you want to add supplemental coverage Medigap (Medicare Supplement Insurance) END Policy If you join a Medicare Advantage Plan, you don’t need and can’t be sold a Medigap policy.

POST - 65 CHECKLIST: 5 THINGS TO DO WHEN YOU GET MEDICARE Fill out an Authorization Form 1) Medicare can’t give personal health information about you to anyone unless you give permission in writing first 2) Make a “Welcome to Medicare” Physical Exam Appointment This free, one-time comprehensive exam is offered during the first 12 months you have Medicare Sign up for MyMedicare.gov 3) MyMedicare.gov is a secure online service where you can access you personal Medicare information 24 hours a day, every day Choose and Join a Medicare Drug Plan (Part D) 4) If you’re new to Medicare, you have 7 months to join a Medicare drug plan Download a Copy of “Your Medicare Benefits” 5) Medicare’s official “Your Medicare Benefits” publication explains the rules about which health care services and supplies Medicare covers

POST - 65 ENROLLMENT: ¡ I am still working for CMU and covered under the CMU medical plan. Do I have to sign up for Medicare when I turn 65? ¡ No. You do not have to sign up for Medicare at age 65. You can wait until you are done working as you can sign up at that time and have no penalty. ¡ You can sign up for Part A while you are still working over age 65 as that does not cost anything; however ¡ If you are covered under the CMU Advantage HDHP with a Health Savings Account (HSA), you will not be able to contribute to your HSA if you sign up for part A. ¡ You can wait and sign up for Part B without a penalty when 14 you retire (you pay extra for Part B)

POST - 65 IMPORTANT HSA CONSIDERATIONS Your HSA is a great way to save for healthcare expenses in retirement ¡ It’s important to note that electing to receive Social Security retirement benefits ¡ automatically enrolls you in Medicare Part A. If you want to continue contributing into your HSA, you cannot begin receiving Social Security payments If you work past your full Social Security retirement age (age 66 or 67 for most ¡ of you), when you retire and begin receiving Social Security payments your payments will be back-dated 6 months. You should stop contributing to your HSA 6 months before you plan to receive Social Security payments (or you will pay taxes and penalties). Your HSA contribution maximum will be prorated based on the month your ¡ HDHP coverage ends (typically the month you retire). 15

POST - 65 ENROLLMENT ¡ I am going to stop work, so how can I enroll for Medicare? ¡ Special Enrollment Period: ¡ You can join during the 8 month period that begins the month after employment ends or CMU coverage ends ¡ You are treated as a new Medicare enrollee and your coverage will begin the 1 st of the month in which you enroll. ¡ To avoid any gap- sign up before you stop work and provide the date you will be losing your employers plan. 16

POST - 65 MEDICARE PART A ¡ Helps Pay For: ¡ Paying for Medicare Part A: Hospital stays ($1,364 deductible, Most people receive Part A § § 1 st 60 days/$341 per day – 61 to premium free 90 days) People with less than 10 years of § Skilled nursing facility (SNF) care Medicare covered employment § will pay a Part A premium Long-term care hospitals § For information, call the Social § Home health care § Security Administration (SSA) Hospice care § 1-800-772-1213 § Blood § 1-800-325-0778 for TTY users § For information, call 1-800- § MEDICARE 17