Research Your Health Insurance Options for 2025 Retirement Business Editor/DLN
Among the many issues you are likely to confront when considering a 2025 retirement is whether and when you need to take action regarding health insurance for you and possibly, if you are married, your spouse. Answers are not necessarily simple and your HR Department might not have all of them readily at their disposal. There are some reasons for this.
- If you are age 65 or expect to be shortly after retirement you need to consider how Medicare benefits relate to retiree health insurance, if any, after discontinuing work for your firm. For those aged 65 at time of retirement or nearly so you may need to consider your company’s retiree health insurance plan, if any, relative to Medicare.
- Your employer might not have a retiree plan. Your employer (especially a small employer) might not have coverage for retirees at all. You may need to know more about Medicare in order to make informed health insurance decisions on retirement. Also, regardless whether there is a company plan, decisions might need to be made regarding your spouse especially if he/she is employed.
- Your major corporate or government employer might have a retiree plan that covers you and your spouse. Your employer’s coverage might be primary and Medicare Part A secondary. You might apply for Medicare A without penalty. If the employer plan is a Medicare Advantage plan then coverages under “B” and “D” may already be included. If the plan is a Medicare Supplement a corresponding prescription drug plan may be offered. For specifics on an employer retiree plan you should definitely consult with your Human Resources Department before retiring. The various employer retiree options are too many and too diverse to be described here.
- If your spouse is employed and you are eligible for coverage under your spouse’s company plan you might opt to have health insurance through him/her. There are choices to be made.
- Applying for Medicare. Medicare is the fallback for persons without an employer plan so it helps to know more about the Medicare system. One of the more straightforward descriptions of what happens with entry into the Medicare system is contained on the Social Security website and is worth consulting even if you do not yet intend to claim Social Security. See https://www.ssa.gov/benefits/medicare/ . Also, Medicare.gov, the official website, which describes “5 things to do before signing up for Medicare.”
- How Social Security Relates to Medicare. The Social Security Administration has some interrelationship with Medicare. If you begin collecting Social Security retirement benefits (whether or not you are still employed), the Social Security Administration might automatically enroll you in Medicare A (the portion of Medicare that covers hospitalization and rehab following hospitalization) and Medicare B (doctors, health care providers, outpatient care and durable medical equipment) then and deduct the Medicare B premium from your monthly Social Security check. If you are not collecting Social Security you will receive bills for payment. See “How to Apply Online for Just Medicare,” at https://www.ssa.gov/benefits/medicare.
- Timing Can Matter. Timing affects both potential penalties for late filing for Medicare B and Medicare D and the ability to sign up for a Medicare Supplement Plan without medical underwriting. Importantly, signing up for a Medicare Supplement is time sensitive. Medicare Supplement plans which are additions to basic Medicare are often preferred especially when there are serious health complications. During the Initial Enrollment Period that begins 3 months before the individual turns age 65 and ends 3 months after turning 65, (except where extended because the individual is fully covered under the employer’s plan) the individual may sign up for a Medicare Supplement without medical underwriting. This is important. Sometimes individuals want to sign for a Medicare Supplement plan later when they are seriously ill and are unable to do so because the initial time has expired.
- Age can make a difference. If your employer does not have a plan for health insurance coverage after leaving employment and your projected retirement date comes at age 65 or older the decision making process is different from those who might retire at a younger age. Retirees under age 65 might look either toward obtaining health insurance through a spouse’s plan or through private insurance generally. COBRA, a government mandated option is a possibility but sometimes prohibitively expensive.
- Seek help if you are unsure. There are insurance agents and insurance brokers who specialize in Medicare issues and can assist.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.