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Health Insurance When I Am Retired

A brief overview...
  • If you retire and are not eligible for other health insurance plans, you can apply for a Marketplace plan
  • Some companies offer life time benefits for their employees that extend into retirement
  • Most people are eligible for Medicare if they retire after 65
  • Medicare Part A is free for most people and counts as minimum essential coverage
  • You have to pay a premium for Medicare Part B and it does not count as minimum essential coverage under the Affordable Care Act

If you do not have retiree health coverage or you are not old enough for Medicare when you retire, you can purchase a health insurance plan on the Healthcare Exchange Marketplace.

If you are eligible for retiree coverage from your job, but not already enrolled, you can qualify for premium tax credits from the Marketplace. However, you will not qualify for premium tax credits if you are already enrolled in retiree coverage.

If you will be turning 65 shortly after you retire, you can enroll in a Marketplace plan until you turn 65 and are eligible for Medicare. You can also purchase a Marketplace plan instead of Medicare if you do not qualify for premium-free Part A.

When you retire and lose your employer-based coverage, you qualify for a special enrollment period. You typically have 60 days to apply for a Marketplace plan with your special enrollment period.

How do I enroll in Medicare?

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Some people get Medicare A and B automatically, while others have to sign up for it. In most cases, if you are already receiving Social Security benefit, you will automatically be enrolled in Medicare.

If you have to sign up for Medicare, you typically have a seven-month period to do so after becoming eligible at 65. The initial enrollment period starts three months before you turn 65 and ends three months after your birthdate.

If you do not enroll in Medicare Part B during this time, you will have to pay a late penalty fee. If you are eligible for premium-free Part A, you can sign up anytime after turning 65 without penalty.

What is Medicare Part A?

Medicare Part A is free for those who worked and paid social security taxes for at least ten years. You can also qualify based on your spouse’s work history.

If you do not qualify for premium-free Medicare Part A, you can still choose to enroll and pay a monthly premium.

Medicare Part A meets the minimum essential coverage requirements under the Affordable Care Act. Part A covers hospital care, medically necessary nursing home care, hospice, and other home health services.

What is Medicare Part B?

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Everyone has to pay a monthly premium to enroll in Medicare Part B. It does not meet the minimum essential coverage requirements on its own. Premium rates can vary depending on certain eligibility criteria, such as income and tax filing status.

Part B covers medical office visits and medical supplies. Additionally, it covers ambulatory services, mental health services, and laboratory tests. Most people enroll in both Medicare Parts A and B, but it is not a requirement.

What are Medicare Parts C and D?

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Medicare Part C, also known as Medicare Advantage, are private insurance plans that work in conjunction with the Medicare program. You must have Medicare Part A and B in order to enroll in a Medicare Advantage plan. Many Medicare Advantage plans also offer prescription drug coverage.

Medicare Part D is prescription drug coverage. Medicare Part B does offer limited prescription drug coverage, but a Part D plan can supplement and expand this coverage. To enroll in a Part D plan, you can contact Medicare directly and give them your policy number and the date that you enrolled.

Each Medicare prescription plan will cover a different list of drugs. Prescriptions will typically be categorized in tiers. Generic drugs will usually be on a lower tier and cost less, while brand name drugs will be on a higher tier and cost you more money.

Health Insurance After Retirement

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You have several health insurance options when you retire. Some companies offer retiree health insurance that you can stay on even after you stop working. If you lose your insurance when you leave your job, you qualify for a special enrollment period to enroll in a Marketplace plan. Most people are eligible for Medicare when they turn 65.

If you or your spouse worked and paid taxes for at least ten years, you are eligible for premium-free Medicare Part A. If you are already on Social Security benefits, you will automatically be enrolled in Medicare.

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