If you are still working and are turning 65, or have passed age 65 and aren’t sure whether you should make the switch, here’s three things to evaluate to determine which path is better for you.
1. Compare the benefits and monthly cost of coverage.
This seems obvious, but a lot of people don’t know what Medicare holds for them. Here’s some information to help.
When you go full Medicare, you’re going to want to get either a Supplement plan or an Advantage plan. The Supplement route is the cadillac coverage with the best network and a $200 medical out of pocket maximum, and runs ~$300 a month, depending on your prescription needs and the company you choose to get the plan through.
An Advantage plan is typically ~$145 a month, and in Kansas City the most popular plans have an out of pocket maximum of $3300.
Also: make sure that when comparing the monthly rates, that you’re doing it right! I have people who bring in their paystubs and forget that they get paid bi-weekly or twice a month. Make sure to do the right math so you’re comparing apples to apples!
2. What’s the cost of coverage for your spouse/dependents?
If your spouse is under 65, coverage could be very expensive. For most seniors, going full Medicare is the best choice if it was just them, but if a spouse is not also Medicare eligible, then it might be better to stay on the group plan until they are.
This isn’t always the case – I also set up health insurance for people who don’t qualify for Medicare, and I can find the costs out for your family members as well. Sometimes the spouse and/or kids will qualify for a subsidy, making their health insurance much more affordable.
3. If you decide to stick with your workplace coverage, DO NOT take part B as a secondary insurance!
Without getting into the weeds too much, when you turn age 65, you can sign up for Medicare part A (free and covers excess hospital bills) and part B (for most people, it’s $145 a month and covers excess doctor bills).
Why am I making a big deal about this? Well, if you get part B while you’re still working, then not only are you paying an extra $145 each month, but the amount it would cover is practically nothing (after your regular insurance does its job), so you’re losing money and getting little in return.
Secondly, and most importantly, activating your part B also triggers a special seven-month time frame where you could get any Medicare plan you want without the insurance companies checking your health history.
You don’t want to waste that time frame. I absolutely recommend taking part A, (free and no special time frames attached); but Part B will do little for you till you go full Medicare, and the special enrollment period that activates along with it should not be wasted.
If you want help evaluating your Medicare and employer options, feel free to reach out to me!