As we age, quality healthcare is more important than ever. Often, employers make health insurance decisions for us, so determining what to do in retirement can be overwhelming. Our goal is to help you better understand your Medicare health plan options so you can make a decision that improves your quality of life in retirement.
Employee BEnefits Medicare and Retirement Workbook
February 2023
MEDICARE AND RETIREMENT WORKBOOK
A s we age, quality healthcare is more important than ever. Often, employers make health insurance decisions for us, so determining what to do in retirement can be overwhelming. Our goal is to help you better understand your Medicare health plan options so you can make a decision that improves your quality of life in retirement. What is Medicare? Medicare is the federal health insurance program for people 65 or older, or younger people with certain disabilities or end-stage renal disease. Original Medicare is made up of two parts: Part A: Inpatient Medical Coverage • Hospital • Skilled nursing • Hospice • Some home healthcare Part B: Outpatient Medical Coverage • Preventative screenings and tests • Doctor visits • Lab work • Imaging: X-rays, CT scans, MRIs • Outpatient surgery • Durable medical equipment Think of Medicare as a benefit through Social Security that provides affordable health insurance for people who may no longer have access to employer group coverage.
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How much does Medicare cost?
Part A is no-cost for most people. It depends on how many quarters you or your spouse worked in your lifetime.
I worked or my spouse worked for at least 40 quarters in our lifetime.
You will most likely qualify for premium-free Part A.
I worked or my spouse worked for 30-39 quarters in our lifetime.
You will most likely pay $278 a month for Part A.
Neither my spouse nor I worked for at least 30 quarters in our lifetime.
You will most likely pay $506 a month for Part A.
In 2023, the standard Part B monthly premium is $164.90. For some people it’s more, for some people it’s less.
What you pay is based on your annual income. Which income range sounds like you?
Individuals: $20,120 or less Couples: $27,214 or less
You may qualify for medical assistance that can help pay your Part B premium.
Individuals: Between $20,121-$97,000 Couples: Between $27,215-$194,000
You will most likely pay the standard Part B premium of $164.90 per month. You will most likely incur an "income-related adjustment amount," which increases your monthly Part B premium.
Individuals: Above $97,000 Couples: Above $194,000
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MEDICARE AND RETIREMENT WORKBOOK
If you think you'll have a Part B income-related adjustment amount, this chart will help you determine what you'll pay.
2021 Income If your yearly income in 2021 (for what you pay in 2023) was:
File individual tax return file joint tax return you pay each month
$97,000 or less
$194,000 or less
$164.90
Above $97,000 and less than $123,000 Above $123,000 and less than $153,000 Above $153,000 and less than $183,000 Above $183,000 and less than $500,000
Above $194,000 and less than $246,000 Above $246,000 and less than $306,000 Above $306,000 and less than $366,000 Above $366,000 and less than $750,000
$230.80
$329.70
$428.60
$527.50
$500,000 and above
$750,000 and above
$560.50
Coverage beyond original Medicare – Why do I need it? Four important things additional coverage will do for you: • Reduce or eliminate costs for covered services and possibly reduce your Part B premium amount; • Set an annual limit on your medical spending for covered services so you can better manage expenses; • Provide affordable prescription drug coverage not included in Original Medicare; • Include valuable extra benefits not included in Original Medicare, such as dental, vision and hearing coverage. Some plan options even include an allowance for over-the-counter wellness items and a no-cost gym membership. Simply put, the benefits of Original Medicare are limited and may not meet all your healthcare needs. There are many different options for Medicare beneficiaries, some as low as $0 in additional premium.
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Options to choose from:
Part C Part C is also called
Part D Part D is prescription drug coverage for Medicare beneficiaries. You can enroll in a stand-alone prescription drug plan (PDP), or you can enroll in a Part C plan that includes Part D (MAPD) sometimes as low as $0 monthly premium.
Medigap Medigap, also called
Medicare Advantage. Part C combines Part A, Part B and often Part D into one easy-to-use health plan. Part C plans offer affordable premiums, sometimes as low as $0.
Medicare Supplement, is a way to “fill the gaps” left by original Medicare. For example, Part B pays for 80% of covered doctor visits. Depending on which Medigap plan you choose, your plan may cover some or all of the remaining 20%.
Do I need Medicare when I'm first eligible? It depends on your employment. Which category do you fall into?
I’m turning 65 and still working. My employer has 20 or more employees. You have options. You can: 1. Remain enrolled in your group health plan (GHP) as primary insurance and delay Medicare enrollment, 2. Remain in your GHP and enroll in Medicare as secondary coverage; 3. Drop your GHP and choose Medicare as primary coverage.
Ask your adviser to compare your GHP benefits to Medicare, to determine if you should delay or enroll in Medicare when first eligible.
I’m turning 65 and still working. My employer has fewer than 20 employees. Your Medicare coverage is primary, your GHP secondary. You need to enroll in Medicare when first eligible. If you do not, you may incur large medical bills. Depending on your needs, it may or may not be beneficial to remain enrolled in your GHP as secondary coverage. Ask your adviser to review. I’m turning 65, and I’m already retired or planning to retire. You most likely need to enroll in Medicare as soon as you are eligible. For most retirees, Medicare is a must. Delaying Part B and Part D enrollment after employer group coverage ends can incur lifelong monetary penalties.
If you think you have a group retiree option through your employer or through veterans’ benefits, discuss with your adviser to see what’s best for you.
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MEDICARE AND RETIREMENT WORKBOOK
How do I get enrolled in Medicare? It depends. Will you be collecting Social Security income when you turn 65?
When I turn 65, I’ll already be collecting Social Security income. • You will most likely be auto-enrolled in Parts A and B, and do not need to apply. • Look for a letter from Social Security about two to three months prior to your 65th birthday with details about your Medicare start date. • Closer to your start date, you’ll receive your red, white and blue Medicare card. • When your Medicare begins, your Part B premium will be deducted from your Social Security income monthly. • If you do not receive this letter or your red, white and blue card, contact Social Security.
I’m turning 65 but plan to delay my Social Security income. • You will need to contact Social Security to apply for Medicare one of three ways: – Apply online at www.ssa.gov; – Visit your local Social Security office; – Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778). • You can apply for Medicare benefits only if you choose or apply for Medicare and income benefits at the same time. • If you delay your Social Security income benefit, you must pay your Part B premium quarterly.
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Once I'm enrolled in Medicare, how do I know which coverage option is right for me? • How often do you use your healthcare? • What was the largest healthcare expense you incurred last year? • Do you have a healthcare budget in mind for monthly premium? • When it comes to healthcare, what is most important to you? • Do you plan to travel? • Do you have any doctors you need to see? • What hospitals are important to you? • What prescriptions are you currently taking? • Do you have access to creditable prescription drug coverage outside of Medicare — for example, through a drug assistance program or through veterans’ benefits?
Meet your Alera Group Medicare consulting team
SCOTT DARDICK MEDICARE CONSULTANT
STEVE DARDICK MEDICARE CONSULTANT
NANCY GLICKSMAN MEDICARE CONSULTANT
BOB PEASE JR. MEDICARE CONSULTANT
ANDREW ZERCHER MEDICARE CONSULTANT
Our licensed and certified Medicare team will answer your questions and help you choose the right Medicare plan for your unique needs. Call or email the Alera Group office to schedule a no-cost consultation. 833-282-8332 | medicare@aleragroup.com We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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Resources For questions about your claims or other personal Medicare information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Extra Help Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles and co-payments related to Medicare prescription drug coverage. To see if you qualify, visit socialsecurity.gov/extrahelp or call 1-800-772-1213 (TTY 1-800-325-0778)
About Alera Group Alera Group is an independent, national firm with more than $1.2 billion in annual revenue, offering comprehensive property and casualty insurance, employee benefits, retirement plan services and wealth services solutions to clients nationwide. By working collaboratively across specialties and geographies, Alera Group’s team of more than 4,200 professionals in more than 180 locations provides creative, competitive services that help ensure a client’s business and personal success. For more information, visit aleragroup.com or follow us on LinkedIn .
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Copyright © 2023 The information contained herein should be understood to be general insurance brokerage information only and does not constitute advice for any particular situation or fact pattern and cannot be relied upon as such. Statements concerning financial, regulatory or legal matters are based on general observations as an insurance broker and may not be relied upon as financial, regulatory or legal advice. This document is owned by Alera Group, Inc., and its contents may not be reproduced, in whole or in part, without the written permission of Alera Group, Inc. Updated February 2023..
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