Why do I need Medicare if I'm covered at work?

In most cases, once you become eligible for Medicare, most retiree policies from an employer or union will require you to sign up for Medicare. In general, retiree insurance plans act as supplemental insurance and pay after Medicare, filling in some of the gaps in Original Medicare’s coverage.

How your specific retiree group health plan coverage will work will depend on the terms of your plan.  It’s best to talk to your human resources staff or your health insurance plan administrator to find out how Medicare and your plan coordinate. Here are a few things for you to ask about:

1.      Find out if you are required to sign up for Medicare Part A, Part B or both to get the full benefits from your retiree coverage. Some retiree coverage might not pay your medical costs during any period in which you were eligible for Medicare but didn't sign up for it.

2.    Ask what your plan covers that’s not covered by Medicare. Does it cover deductibles or co-insurance? Can you see any doctors you choose or are you restricted to a network of doctors and health care providers? Does it cover extra days in the hospital? Does it include coverage for vision, dental or prescription drug coverage?

3.    Don’t assume that your coverage and costs as a retiree will be the same as an employee. Verify this. If you have a spouse, check whether he or she will also be covered. Employers aren't required to cover retirees, and they may provide different benefits, premiums, or even cancel coverage.

4.     Find out if your retiree plan provides ‘creditable coverage’ for prescription drugs. If it is not creditable coverage (as good as, or better than Medicare Part D) you will be charged a penalty should you need to enroll in Medicare Part D (drug coverage) in the future.

Your decisions about health care coverage are some of the most important choices you’ll make in the retirement planning process. I invite you to learn more about Medicare and the options you have. Please join me for my class, Getting Started with Medicare, presented at local colleges, libraries and community centers. For a complete list of upcoming dates and times for classes, you can click here to visit my website. . I look forward to seeing you in class.