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Should we stay on your employer health word or get Medicare?

Don't make a health coverage preference with long-term consequences formed on short-term conditions, advises Phil Moeller. Photo by Joe Raedle/Getty Images. Related words: Medicare, senior, aged age, health care,

Medicare Maven Phil Moeller answers your Medicare questions. Photo by Joe Raedle/Getty Images.

Editor’s Note: Journalist Philip Moeller, who writes widely on health and retirement, is here to yield a Medicare answers we need in “Ask Phil, a Medicare Maven.” Send your questions to Phil.


I will get to as many questions as we can here, though greatfully accept my apologies that we am not means to answer everyone’s questions.

Ellen – N.Y.: we am branch 65 in Aug and am still operative and devise to continue operative until age 70. we can't collect Social Security until we spin 66. we devise on canceling my employer’s health word and enrolling in Medicare by this Aug when we spin 65. How do we compensate for Part B this initial year on Medicare if they can’t take it out of my Social Security check given we won’t be collecting Social Security for during slightest another year?

Phil Moeller: First off, Ellen, we would advise we to ensue really delicately here. In many situations, we will be improved off gripping your employer health insurance. Most likely, we will be entitled to do this. If we have finished your task and dynamic that Medicare is your best deal, afterwards by all means we can leave your employer plan. This could be a one-way trip, however, as a devise competence not have to take we behind should we after change your mind. As for your Medicare premiums, we will need to compensate them directly to Medicare any 3 months. You can pointer adult for a program that will concede these payments from your bank account.


Robert – N.Y.: we have employer-provided health insurance. we was told that during age 65 my employer health word would spin my Medicare Part B word and that any premiums collected from me by Social Security would be rebated to me by my employer health insurance. Is this true? Also, Plan D is drug coverage, correct? we have drug coverage from my employer health insurance. Will this meant that we do not have to enroll in Plan D coverage?

Phil Moeller: This is not a approach it would work. By law, employer organisation health word skeleton contingency continue to cover we at any age so prolonged as we continue working. Turning 65 would not force we to take Medicare so prolonged as you’re still working. The usually difference is if your employer has fewer than 20 people (or fewer than 100 if we are disabled). In this event, you’d need to get Medicare, given it would spin your primary health insurance, and your employer devise would spin a delegate payer of health claims, and it competence cover some things that Medicare would not cover.

Employers have been devising all sorts of ways to extent their bearing to rising health word premiums, though if they continue to offer organisation health insurance, they contingency reside by this rule. Still, improved protected than sorry, so we advise we to check with your employer. In any event, we possibly would be on an employer devise or on Medicare if you’re retired. You would not be on both, definition that we would not have Medicare premiums deducted from your Social Security payments if you’re still lonesome by employer health insurance. And there would be no rebates involved. As for Part D, if we continue to work and have what’s called a “creditable” drug devise by your employer devise — definition a coverage is as slightest as good as a standard Part D devise — we can keep your employer drug coverage and do not need a Part D plan. Your employer is ostensible to yield an annual notice that a drug coverage is creditable.


Daniel – Fla.: we am 84 and live on my Social Security. we accept a Low-Income Subsidy for my medications. How do we request to get Part B paid for by Social Security and not have it taken out of my retirement check any month?

Phil Moeller: If your income is low enough, we can get assistance with your Medicare premiums. If this happens, your Part B reward would be reduced or even eliminated. To find out, we should get in hold with a Florida advisor who works for a State Health Insurance Assistance Program (SHIP). They can assistance we figure out if you’re authorised for any use and also assistance with your application. There is no assign for this service.


Nancy – Ore.: About 3 years ago, my father declined to enroll for Medicare, as he is lonesome by my workplace health plan. His health has deteriorated, and we am wondering if it creates clarity to pointer him adult on Medicare now to assistance cover costs my workplace health devise doesn’t cover? Can he do this though a penalty?

Phil Moeller: If it creates clarity to do this, he will not face a late-enrollment penalty. But we need to ensue delicately here, given if he leaves your plan, he competence remove entrance to it in a destiny if we change your mind. If he has possibly filed for his Social Security or has adequate work knowledge to validate for benefits, he can get premium-free Part A sanatorium word from Medicare. He can do this and still stay on your workplace plan. Then, if he is hospitalized, he would have to compensate a deductible of $1,288 before Medicare coverage would flog in. It would compensate delegate to your workplace plan, though it’s probable this would still be a good understanding for you.

Otherwise, he would need to leave your plan. He would get Parts A and B of Medicare, a Part D drug devise and possibly a Medigap or Medicare Advantage plan. You would afterwards need to demeanour during a costs of his Medicare, see how many improved it would cover him than your workplace devise and afterwards review these costs with what you’re profitable to have him on your workplace plan. In some cases, employers offer health remuneration accounts to compensate some of these costs for people who leave a plan. If your employer offers these accounts, we could see if this would make a preference some-more attractive.


Joe – Fla.: My mother will retire in dual years during 65. we will be 63 then. we am infirm and have had a liver transplant. Our large worry is after she loses her association health benefits, how do we means my immunosuppressant drug? we take Rapamune.

Phil Moeller: This is a tough one. Unless your mother decides to keep working, we will be forced to get health word on a Florida state sell set adult underneath a Affordable Care Act for dual years (until we spin 65). You should review skeleton and see that ones yield improved deals on your medication. You also should check out either we can get manufacturer discounts for this drug. Of course, a lot can change in a subsequent dual years. But right now, this is a choice we have. Good luck!


Paula – N.J.: My hermit is 67. He has Medicare Part A though not Part B, given he is operative and has an employer-sponsored health devise with medication coverage.  Does he have to request for a Medicare Part D drug devise also? In addition, does he have to request for Social Security and postpone given he is working?

Phil Moeller: The brief answer is that your hermit doesn’t need to do anything now. Check my answer above to Robert’s doubt on a theme of his health insurance. As for Social Security, his monthly advantage remuneration will arise during a rate of 8 percent a year until it reaches a limit volume during age 70. we support watchful until afterwards to record unless he has life-shortening health issues or dire stream spending needs.


Hilary – Ariz.: For financial reasons, we took early retirement during 62. we have a tiny British grant that has discontinued by scarcely $100 a month this year due to sell rates. we incited 65 on Jan 1, so my initial Medicare reward of about $104 was deducted from my Dec 2015 Social Security payment, that occurs any month. My income is now next $1,000 a month, and my lease and vital losses now surpass my income. we am also disabled (polio in 1953), though we have never claimed disability. we am perplexing to figure out what to do though with no success so far.

Phil Moeller: If your health is good, your lowest-cost Medicare resolution would be a zero-premiums Medicare Advantage plan. You many expected would have to continue to compensate that monthly premium, that is for Part B coverage. Part B doesn’t cover all your needs. But a zero-premium Medicare Advantage health upkeep classification (HMO) devise with a bundled-in Part D drug devise (normally shortened as an MA-PD plan) would strengthen we from inauspicious health and drug expenses. Of course, you’d need to be gentle with regulating a doctors, hospitals and other health caring providers in a plan’s network. You don’t contend if we also are authorised for Social Security benefits, though if we validate for premium-free Part A Medicare coverage (which we assume we do if your usually stream Medicare remuneration is for Part B), afterwards we competence try either we could acquire some additional income from Social Security. As we competence know, your British grant competence revoke your Social Security income due to Social Security’s Windfall Elimination Provision. The United States and a United Kingdom have what’s called a totalization agreement that competence impact your WEP reductions in Social Security. Here’s an online tool we can use to find out more.

As for your childhood polio, this condition competence have entitled we to progressing Social Security Disability benefits, though it will not be a basement of any advantages now given we have been late for several years. Besides, these advantages would not boost a volume of income we competence be due from Social Security. If your grant is your usually source of income, we should try either you’re authorised for low-income assistance programs. You could call a advisor for a State Health Insurance Assistance Program (SHIP). There are broader old-age programs that we also could explore. A good source here would be a Arizona associate of a National Association of Area Agencies on Aging. Good fitness to you.


Rick – Wash.: we am late and will be 65 this November. we am not collecting Social Security during this time. we am also lonesome by Federal Employees Health Benefits as my word plan. Does requesting for Medicare and Social Security spin some-more difficult or easier if we am already lonesome by FEHB?  Do we have to compensate for Medicare in further to my FEHB payments?

Phil Moeller: Your FEHB devise is a difference to a order that retirement health coverage always pays delegate and that Medicare is so required. Your retirement coverage should continue to compensate primary and we competence not even need Medicare. Check with your advantages folks on this. If this is a case, afterwards we need do zero when we spin 65. Social Security, that administers Medicare enrollment, competence send we a Medicare label after your 65th birthday. Assuming we won’t need Medicare, we should decrease Medicare and send a label back. As for Social Security, this should be a apart process. Assuming we don’t have a sovereign grant that competence run into a WEP manners addressed currently in Hilary’s doubt above, your focus for Social Security should not be influenced by your retirement health coverage. As for a timing of your filing, we should be wakeful of both early filing reductions for claims before age 66, as good as delayed retirement credits should we wait until after branch 66 to file.

Article source: http://www.pbs.org/newshour/making-sense/should-you-stay-on-your-employer-health-insurance-or-get-medicare/

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