It can be a difficult decision to make when determining the most appropriate and most affordable method of supplementing your original Medicare coverage. This decision can become even more complicated when you are eligible for Employer Group Health Coverage or Retiree Plans. There are many things to consider when analyzing which plan is the most appropriate and most affordable in supplementing your original Medicare coverage. There are so many alternatives to supplementing original Medicare coverage that at times it can seem overwhelming. However, the Benefit Specialists at Medicare Pathways are trained and eager to assist you in determining the most affordable and most appropriate method to supplement your original Medicare coverage.
Some things to take into consideration regarding Employer Group Health Coverage or Retiree Plans include the following:
- Employer benefits and costs vary widely from plan to plan
- You may be paying much more for your group plan than you would if you got an individual plan
- Some plans cover costs that are not covered by original Medicare Part A and Part B, such as dental and vision benefits
- Some have large deductibles that must be met before any benefits will be paid
- Some retiree health plans act like Medicare Supplement plans by covering original Medicare Part A and Part B deductibles and cost sharing
- Some retiree health plans are offered through Medicare Advantage Organizations or non-Medicare managed care plans
- Employers can change the benefits, cost sharing or premiums for these plans, or drop the plan at will
- Retirees can also lose their benefits if a former employer files for bankruptcy
Each of the foregoing situations will be taken into consideration by the Medicare Pathways Benefit Specialist when comparing your Employer Health Coverage Plan or Retiree Plan with the Medicare Supplement plans and Medicare Advantage plans that are available in your area. Medicare Pathways works with 20 different insurance companies which allow the Benefit Specialist to compare your Employer Health Coverage Plan or Retiree Plan benefits and costs with numerous plans to determine the most affordable and most appropriate method to supplement your original Medicare coverage. The Benefit Specialists at Medicare Pathways will assist you in making a side-by-side comparison of all aspects of coverage and costs before making a recommendation regarding the most appropriate and most affordable method of supplementing your original Medicare coverage.
One major issue that must be considered before investigating alternatives to your Employer Group Health Coverage or Retiree Plans involves health care coverage for other individuals in your household that are covered by your Employer Group Plan or Retiree Plan. Specifically, ask yourself the following question:
Are there other individuals that are covered by the Group Health Plan or Retiree Benefits that will lose their health care coverage should you switch to a Medicare Supplement or Medicare Advantage (also known as “MA”) plan because these plans are individual insurance and do not cover other family members?
If the answer is yes, then remaining on your Employer Group Health Coverage or Retiree Plan may be the best option for you unless the other individuals have other means of obtaining health care coverage. Again, the Benefit Specialists at Medicare Pathways will help you determine if this is the most appropriate method to supplement your original Medicare coverage.
So, what exactly is Employer Group Health Coverage or Retiree plans? These are health insurance plans that some people receive as a retirement benefit from their or their spouse’s former employer or union after they reach 65 years of age or retire from the company. These plans allow continued coverage of dependents in the household after retirement. These plans supplement your original Medicare coverage.
However, with so many different Medicare Supplement and Medicare Advantage plans on the market it is important to investigate and analyze your options for supplementing your original Medicare coverage even if you have Employer Group Health Coverage or Retiree Plan. It is equally important not only to compare the premium amounts of your Group Health Coverage Plan or Retiree Plan to Medicare Supplement plans or Medicare Advantage plans, but to take into consideration all cost sharing that is required of each plan. Cost sharing is any out-of-pocket costs, excluding your premium that you are required to pay for your medical services. Cost sharing includes deductibles, co-pays and coinsurances.
In order to do a thorough and complete comparison of your Employer Health Coverage Plan or Retiree Plan it is helpful to obtain a Summary of Benefits or Outline of Coverage of the Plan. Then, when contacting Medicare Pathways, you have the information available regarding premiums and cost sharing so the Medicare Pathways Benefit Specialist can make an educated recommendation regarding the most affordable and most appropriate method of supplementing your original Medicare coverage.
It is Medicare Pathways goal to make a recommendation of the most affordable and most appropriate method of supplementing your original Medicare coverage. It is not the goal of a Medicare Pathways Benefit Specialist to simply focus on making a sell. If it is determined that it is in your best interests to remain with your Employer Health Coverage Plan or Retiree Plan that is the recommendation that the Medicare Pathways Benefit Specialist will make for you. Additionally, your Benefit Specialist will follow-up with you periodically throughout the plan year to ensure you are satisfied with your plan and not having any problems. If problems should arise, the Medicare Pathways Benefit Specialist will assist in securing a resolution of the problem.
With regard to changing plans, it is important to note that joining a Medicare Advantage plan a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO) may limit or end your employer or union coverage, both for you and/or any family members covered by your plan. Carefully read any materials your employer or union sends you. You can also find lots of helpful information and articles by visiting our website at www.medicarepathways.com or by calling 1-866-466-9118 and speaking with a Benefit Specialist at Medicare Pathways that specializes in Medicare insurance in your state.
Medicare Pathways, Inc. 1-866-466-9118