Q& A from Senior Health Insurance Information Program

Local SHIIP counselor Montie Redenius provided answers to a common question about Medicare.

QUESTION: I currently work for a company that includes health insurance and prescription drug coverage as part of my compensation package. I will turn 65 in two months at which time I plan to retire. After my employment ends, my health insurance and prescription drug coverage also end. What are my options?

ANSWER: First, you must decide whether you going to start drawing Social Security at age 65 or are you going to delay drawing it? If you are going to start drawing your Social Security, you will automatically be enrolled in Medicare Part A (hospitalization) and Part B (physician services). The premium for Part B (there is no additional premium for Part A) will be deducted automatically from your Social Security payment.

If you are married and your spouse is still working for an employer with 20 or more employees and you can be covered under your spouse’s employer health plan, you can defer Part B coverage until such time as your spouse quits working. At that time, you will have to re-enroll in Part B. If there are less than 20 employees, the employer plan does not have to pay primary and you may need to enroll in both Medicare Parts A and B.

If you are going to delay drawing your Social Security, you will have to contact Social Security to enroll in Medicare Parts A&B. If you do not draw Social Security, you will be billed quarterly for the premium.

Medicare has deductibles and co-payments so you might want to consider purchasing a Medicare supplement plan that will cover these health expenses plus some additional coverage not offered by Medicare. Medicare and Medicare supplements do not cover prescription drugs so you will want to purchase a prescription drug plan (Medicare Part D). You can enroll in this plan yourself by going to www.medicare.gov or you can receive free assistance from a SHIIP counselor who can help you compare the various plans available.

Another option is to purchase a Medicare Advantage plan. This policy is issued by a private insurance company so your Medicare coverage will be provided by them. The Medicare Advantage Plan includes Medicare Part A and B and may include Part D coverage. You still have to pay the Part B premium, which Social Security will withdraw from your Social Security payment. The main difference is that the Medicare Advantage plans have networks so you have to make sure your medical service providers are in the network and will accept the plan.

If you still have questions, you may contact a SHIIP volunteer at Grinnell Regional Medical Center by calling 641-236-2588. Four SHIIP volunteers are available to help you in Poweshiek County.