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New to Medicare & Have Retiree Plan

If you are fortunate enough to have health insurance through your current or former employer, you may not need to take any additional steps once Medicare begins. However, it’s important to ask yourself a few questions to make sure you’re adequately covered, so that you don’t experience penalties later or pay a lot more for coverage that may not be as good as Medicare insurance. Click on the questions below for help determining whether you need private Medicare insurance or whether your employer’s plan is sufficient.

  Will my plan provide creditable drug coverage?

Employer plans generally include prescription drug coverage. As far as Medicare is concerned, there is only one question about this coverage that matters, which is whether it is as good or better than Medicare coverage. If it is, it is considered creditable, and there is no need to take out a separate Part D prescription drug plan. If your coverage is not creditable, you will need to purchase some type of Part D plan to avoid a penalty later.

  Is my plan a good deal?

Employer plans vary widely in their benefits. In fact, unlike with Medicare insurance, there are few rules and laws about what a plan must cover or not cover. As a rule of thumb, if you are paying less than $100 a month for your retiree health plan and it includes creditable drug coverage, you are probably getting a good deal. If not, it may be worth exploring private individual insurance options to see if you can save money. However, it’s important to note that if you do leave your employer policy, you may not be able to return to that plan in the future.

  Do I have a spouse or other dependents who depend on my plan?

Getting health insurance for people under 65 can be hard and expensive. People in retiree health plans with spouses or dependent children may find that even if they are paying a lot of money for their health insurance through an employer, they have little choice until their dependents are able to get alternative health insurance or Medicare.

  If I leave my employer plan, can I return?

Employer health plans vary widely from company to company. Some employers allow people to enter and exit their plan as they see fit, while other employers see health insurance as a one way door where someone can only leave the plan, but never return. Depending on your situation, leaving the plan may be appropriate, but it’s always worth checking with your benefits administrator to understand the implications of leaving before making that shift.

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