Today more than one third of all baby boomers turning 65 continue to work after going on Medicare.
For those that have healthcare through their employers, their focus becomes making sure they don’t get a part B penalty rather than making sure they are saving the most on their healthcare. “How do I avoid the Part B penalty” is the biggest question asked by those continuing to work after going on Medicare. According to Google, it is a very largely searched question on their platform. But is a big, big mistake. One should not be concentrating on avoid a penalty initially, but rather whether to replace the employer health coverage with Medicare Part B.
For too many individuals the “devil you know is better than the devil you don’t know” keeps them from even exploring the possibility that a Medicare Advantage plan might be better than their employer’s coverage. Having a Medicare Advantage plan requires one to have Part A and Part B. Part B has a premium. But so does most employer healthcare coverage plans. One of the biggest differences between MOST Medicare Advantage plans and MOST employer sponsored plans is the deductible. While many employer plans have health care deductibles ranging from $1,500 a year to over $5,000 a year, most Medicare Advantage plan have a ZERO deductible for health care. Another difference between employer plans and a Medicare Advantage plan is that many Medicare Advantage Plans have hearing, dental, and vision coverage included. This is almost always a separate purchase for employer plans. Most Medicare Advantage plans also come with free gym memberships through SilverSnickers, as well as other benefits like a monthly over the counter medication allowance, transportation for doctor visits, medical alert systems, and much more. They also include Rx drug coverage.
There are times when the employer’s plan is the better option. In my years of working with people going on Medicare, I have recommended individuals stay with their employer’s plan a few times. The key is that no one knows which path is correct until they do an actual comparison.
With so many Medicare Advantage plans available where should one start?
It is a good idea to narrow down the available Medicare Advantage plans to the best one for you before comparing to your employer’s plan. A good Medicare broker, like those of us at Medicare Made Simple and Boomer Select Agency, will run your current drug list against the database of ALL plan available in your county. This should narrow it down to just or two plans. You will then need to choose between those two based on personal preferences and then compare that one to your employer’s plan. All broker’s services to you are free under federal law.
Comparing Apples to Apples
One thing to compare is premiums. When doing so keep in mind the Part B premium and Medicare Advantage premium, if there is one. Compare deductibles. Compare doctor visit co-payments. Compare the monthly cost for drugs based on your current monthly cost and the estimate you get from the broker. Don’t try to compare every co-payment. Only compare about five things. Just make sure those five things are the once that affect you.
What about my spouse that is not on Medicare yet?
One of the biggest hurdles for many working individuals who are going on Medicare earlier than their spouse is that they need to keep coverage on their spouse. There are thee options for this to consider when determining with path is best for you.
1. Can your spouse get coverage through their work? Even if your spouse’s employer is not in open enrollment, your becoming eligible for Medicare and your spouse losing your employer coverage creates a “life event” which would allow your spouse to get covered through his/her employer without waiting for the next open enrollment.
2. Ask your employer if your spouse can stay on your employer coverage without you because of your going on Medicare. Some employers will allow this. You don’t know until you ask.
3. Bridge to Medicare insurance plans. If your spouse is at leas 62, he or she can get a private Bridge to Medicare insurance plan. These are plans specially designed to allow individuals who are still working at age 65 to take advantage of the Medicare they have earned without leaving their spouse uncovered. Just remember to add the premium for the Bridge to Medicare plan into your comparison