Is it a no-brainer to cont w/emp health ins vs medicare

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Topic Author
HogsAndApples
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Is it a no-brainer to cont w/emp health ins vs medicare

Post by HogsAndApples »

I'm helping someone who will be 65 shortly navigate their medical choices. He is employed ( and has access to employer health care coverage. The big question appears to be whether it makes more sense to go with Medicare now or stay with the employee health insurance plan. His wife is on his medical coverage. Here are the options with his CURRENT employer:

1. DEFER Medicare Part A, B, D AND keep employer health care coverage.
2. Take Medicare Part A, AND keep employer health care coverage (double coverage option - here I am thinking the employee insurance covers Medicare Part B?).
3. Take Medicare Part A, B, D AND keep employer health care coverage (double coverage option).
4. Take Medicare Part A, B and D and SUSPEND employer health care coverage. He can always, they say, take it up again in the future.

5. He has one other option, he can opt for his Medicare coverage through a PREVIOUS employer. He would receive a $60 stipend per month from the previous employer towards Medigap coverage should he enroll through their service, but his wife would probably pay a higher cost for coverage (she'd be grouped in with the retired health insurance pool) than if he stayed with his current employer where rates are much lower.

The current rates for the employer health insurance plan are not yet available - my thought is the employer insurance would probably be cheaper than purchasing Medicare Part B and/or D and that assuming the cost is lower with current employer - staying with current employer and option #1 would be best.

My question, has anyone deferred Medicare before and/or have any thoughts or comments that I might pass along to this individual to help him navigate this decision?
mhalley
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by mhalley »

This can be a somewhat confusing question, but the good news is that he seems to have lots of different options. I would recommend you try out rubinhealth.com. He has a show on Dr Radio that answers insurance questions. You could either call in to the show, or sign up and post a question on his web site. The show is called Healthcare Connect, and airs on Thursdays 10pm-MN EST. the phone number is 877-nyudocs (800-698-3627). I think you could email the question to docs@siriusxm.com also, and put healthcare connect or andrew rubin in the subject.

http://rubinhealth.com/index.php?option ... &Itemid=62

Here is some govt. info: http://www.medicare.gov/publications/pubs/pdf/02179.pdf
Mike
Calm Man
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by Calm Man »

I will have a similar option in 3 + years. There is no way I won't sign up fro Medicare A and B, period. I don't care if I have double or triple or quadruple coverage. Regarding Part D, I am assured that if I do the company retiree program that the D is one of those that qulaifies to convert over. Who the heck knows, I'll probably sign up for Part D too. I just think the risk of a catastrophic medical cost scenario outweighs a few hindered dollars a month but that's me.

There is no hospital that doesn't take Medicare. And I doubt you could get those wacky bills from other threads where doctors aren't in networks that don't take Medicare. (Imagine how your Congress person would jump all over it if a person taking care of a senior in an ER didn't take Medicare or a second surgeon didn't.) Some things just aren't worth the few hundred a month in savings, period.
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GerryL
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by GerryL »

Warning: If he chooses to stay on employer plan, he needs to think twice (three, four times) before signing up for any part of Medicare. If his employer should later push him to a high-deductible plan (HDHP) he would not be eligible for a health savings account (HSA) as these are out of bounds for anyone signed up for Medicare.

This is what happened to me last year. I followed conventional wisdom and signed up for Part A as I turned 65 and within a few months my employer was strongly encouraging the HDHP for 2014. I have read that an increasing number of companies are switching their offerings to only HDHPs. It took 6 frustrating months to un-enroll from Medicare so that my HSA would not get me in trouble with the IRS.

If the employer plan is decent -- and creditable, meaning Medicare considers it a valid stand-in -- there is no reason to rush into Medicare. He should check that with his HR department. They should (eventually) send him a form validating that his prescription coverage is creditable so he will not be penalized for deferring Part D coverage.

One more warning: If he does defer signing up for Medicare, he will probably want to explicitly inform his healthcare provider and insurance company. I discovered that they may automatically try to bill Medicare as soon as you reach the magic age. Apparently they think that is efficient.
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HogsAndApples
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by HogsAndApples »

I very much appreciate all your replies. Your comments and thoughts speak to the details and issues one wants to have as they forge forth on issues of this kind. THANK YOU!

Oddly, the current employer's benefits department appears to be particularly clueless about employees who qualify for medicare. Other than giving him a very simple chart which basically shows the options above the employee he spoke with said she knew nothing other than what was on the chart and it was up to him to figure it out. He is elevating it to someone who may be knowledgeable. If he can't talk to a knowledgeable person at his current place of employment, he may well opt out of his current employer's options and go with his former employer's plan Medicare option so his wife will also have coverage.
Topic Author
HogsAndApples
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by HogsAndApples »

So the upshot appears to be there are 4 choices for my friend - my questions:

1) Am I missing anything - are there other details to consider?
2) Are there pluses to being on Medicare?
3) Is there some easy way to compare the cost of the plans over time? Or is it a no-brainer to simply take Option #1 and/or Option #2 (if available)? I say no-brainer because of the stipend for the husband and wife. Obviously the cost is less expensive initially if he stays with his current employer.
4) Turns out he needs to make his decision relatively quickly - his current employer insists he make his decision with everyone else in the annual November election period.

Both my friend and his wife are healthy.

Choice 1: Go back with his prior employer and pick up Medicare A, B, D and Medigap coverage with a $65 per month stipend AND his wife will pickup the companies higher cost (retiree group insurance) .... approx $450 per month (looks like an accurate figure). She then is eligible for a $65 stipend WHEN she reaches 65 in 6 years. If he does not choose to go back with his former employer by the end of this year, he loses the stipend benefit for himself and his wife.


Choice 2: Same as option #1, except his wife looks for insurance on her own through the state insurance fund which might be less expensive and then she picks up Medicare through his previous employer in 6 years. Am not actually sure his wife would qualify for a state insurance fund as she would have an insurance care option, but thought he should check it out. -- a wild goose chase?


Choice 3: Stay with his current employer and take Medicare A ... AND ... FORFEIT the stipend his previous employer would have paid him and spouse: $130 per month. He believes and will double check that the plan is creditable by Medicare.


Choice 4: Defer Medicare altogether and husband and spouse will stay with current employer: $4000 / year. What is the benefit of deferring?

[Edited out dollar amts.]
Last edited by HogsAndApples on Thu Oct 16, 2014 4:47 pm, edited 1 time in total.
Topic Author
HogsAndApples
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by HogsAndApples »

I could use some help figuring out the math on the choices ... The basic choice is to either stay with his current employer or go on Medicare with the stipends through his previous employer. The latter is the more expensive option for 6 years until his wife goes on Medicare.

Any advice? Or is there a type of expert in this field that might be help?

[Edit: thanks anyway - I see how to do the math - apparently I just had to talk it "out loud" here on the board]
mur44
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by mur44 »

I need more information on the employer health insurance coverage,
employee premium amount, spouse's age.

Medicare Part A (Hospital insurance) is free if one has
40 quarters of work history. It is free to spouse as well.

If you PM me, I may be able to assist you.

calm man:

Help is available to assist Medicare beneficiaries at your county level:
(Please contact them when you are ready to retire)

https://shipnpr.shiptalk.org/findcounselor.aspx


Disclosure: I am a Certified Volunteer Medicare Counselor from NJ
Topic Author
HogsAndApples
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Joined: Thu Feb 02, 2012 4:52 pm

Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by HogsAndApples »

mur44, Yes help is available at the county level and he contacted that organization last week. Unfortunately they told him they are only available to discuss Medicare explicitly. Therefore they were unable to help with the current versus previous employer issues. I will suggest he try back, perhaps he talked with someone not as well versed as another.

He was hoping to shortlist the decision tree a bit by making the decision at the top of the tree (previous versus current employer) rather than looking at each option under both employers especially as he has an additional time constraint - he has to make a decision from his current employer during the November benefit elections which shortens the time he has to make a decision.

I will pm you and I thank you for your suggestion!
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Re: Is it a no-brainer to cont w/emp health ins vs medicare

Post by LadyGeek »

This thread is now in the Personal Finance (Not Investing) forum (insurance).
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