Relationship between employer’s retiree coverage and medicare (medical, plan, supplement)

[Xenah]

My question concerns the relationship between an employer’s retiree health coverage and Medicare.

I am recently retired. My current retiree medical coverage is an HMO provided by my former employer.

I will soon be Medicare eligible and am convinced a Medigap is my best Medicare option; however, through the former employer I will be limited to choosing between several HMOs. As I understand it, the employer’s retiree health plans are neither Medicare Advantage plans, nor Medigap plans.


If I sign up with one of the former employer’s plans for Medicare-eligible retirees, will I loose eligibility to sign up for a Medigap plan in future years? I am very concerned with being required to undergo underwriting.


Thank you.

[Mtn. States Resident]

Originally Posted by Xenah

My question concerns the relationship between an employer’s retiree health coverage and Medicare.

I am recently retired. My current retiree medical coverage is an HMO provided by my former employer.

I will soon be Medicare eligible and am convinced a Medigap is my best Medicare option; however, through the former employer I will be limited to choosing between several HMOs. As I understand it, the employer’s retiree health plans are neither Medicare Advantage plans, nor Medigap plans.


If I sign up with one of the former employer’s plans for Medicare-eligible retirees, will I loose eligibility to sign up for a Medigap plan in future years? I am very concerned with being required to undergo underwriting.


Thank you.

An enrollees can change from year to yesr. But, if you are really soon-to-be retired, check out the info yourself. Medicare has their 800 call line open 24 hrs./day, plus some things online. No need to wonder, contact Medicare and ask for your state. Medicare is a Federal program, but each state determine which insurance options they will have in their state. Not to worry, Medicare knows which companies and plans each state has.

Good luck

MSR

[Qwerty]

Originally Posted by Xenah

My question concerns the relationship between an employer’s retiree health coverage and Medicare.

I am recently retired. My current retiree medical coverage is an HMO provided by my former employer.

I will soon be Medicare eligible and am convinced a Medigap is my best Medicare option; however, through the former employer I will be limited to choosing between several HMOs. As I understand it, the employer’s retiree health plans are neither Medicare Advantage plans, nor Medigap plans.


If I sign up with one of the former employer’s plans for Medicare-eligible retirees, will I loose eligibility to sign up for a Medigap plan in future years? I am very concerned with being required to undergo underwriting.


Thank you.

This is a difficult question to answer without knowing the plan specifics. One state plan that I am familiar with is technically a MA plan for the retirees, however the plan pays providers like it is a gap plan and because of that, most providers are willing to take that plan where they would not normally accept a MA plan. They have several HMO options as well, however, they are able to change their primary clinic as often as they want so the snowbirds, for example, can change when they go south in the winter, then change back as they go back home for the summer. It would be best to take to the plan administrator, your HR people or even CMS if it is a government plan in any way, and ask them the specifics. One thing on this plan above, though, if they leave the plan to go to a straight gap plan, they are not eligible to re-enroll in the retiree plan, ever.

[Ariadne22]

Originally Posted by Xenah

If I sign up with one of the former employer’s plans for Medicare-eligible retirees, will I loose eligibility to sign up for a Medigap plan in future years? I am very concerned with being required to undergo underwriting.

You appear to be in NC - not a guarantee issue state.

So, yes, you may be required to undergo medical underwriting if you leave the retiree plan to enroll in a regular Medigap outside the Medicare Initial Enrollment Period.

https://www.medicare.gov/sign-up-cha...s-a-and-b.html

Many states allow Medigap enrollment for new residents w/o medical underwriting - or qualified underwriting - such as an exclusion for a preexisting condition for a period of six months, after which you would have full coverage. So, a way around this would be to change your state of residence temporarily and enroll in new coverage in the new state - and then later moved back to NC. (a lot of work)

Best to contact your state on its rules. A place to start would be:

North Carolina SHIP Website:
www.ncdoi.com/SHIIP/Default.aspx
Phone: 855-408-1212
Program Name:
About: The Seniors’ Health Insurance Information Program (SHIIP) counsels Medicare beneficiaries and caregivers about Medicare, Medicare supplements, Medicare Advantage, Medicare Part D, and long-term care insurance. The counselors on our toll-free line offer free and unbiased information regarding Medicare health care products. We also help people recognize and prevent Medicare billing errors and possible fraud and abuse through our NC SMP Program.

Not all carriers might impose medical underwriting, but expect that they will.

[greg92040]

Originally Posted by Xenah

My question concerns the relationship between an employer’s retiree health coverage and Medicare.

I am recently retired. My current retiree medical coverage is an HMO provided by my former employer.

I will soon be Medicare eligible and am convinced a Medigap is my best Medicare option; however, through the former employer I will be limited to choosing between several HMOs. As I understand it, the employer’s retiree health plans are neither Medicare Advantage plans, nor Medigap plans.


If I sign up with one of the former employer’s plans for Medicare-eligible retirees, will I loose eligibility to sign up for a Medigap plan in future years? I am very concerned with being required to undergo underwriting.


Thank you.

In Section 1, page 16 in "2015 Choosing a Medigap Policy" it says.

Employer coverage


If you have group health coverage through an employer or union, because
either you or your spouse is currently working, you may want to wait to enroll
in Part B. This is because benefits based on current employment often provide
coverage similar to Part B, so you would be paying for Part B before you need
it, and your Medigap Open Enrollment might expire before a Medigap policy
would be useful. When the employer coverage ends, you’ll get a chance to
enroll in Part B without a late enrollment penalty which means your Medigap
Open Enrollment Period will start when you’re ready to take advantage of it.
If you enrolled in Part B while you still had employer coverage, your Medigap
Open Enrollment Period would start, and unless you bought a Medigap policy
before you needed it, you would miss your Open Enrollment Period entirely.
If you or your spouse is still working and you have coverage through an
employer, contact your employer or union benefits administrator to find out
how your insurance works with Medicare. See page*24 for more information.

[greg92040]

Originally Posted by Xenah

My question concerns the relationship between an employer’s retiree health coverage and Medicare.

I am recently retired. My current retiree medical coverage is an HMO provided by my former employer.

I will soon be Medicare eligible and am convinced a Medigap is my best Medicare option; however, through the former employer I will be limited to choosing between several HMOs. As I understand it, the employer’s retiree health plans are neither Medicare Advantage plans, nor Medigap plans.


If I sign up with one of the former employer’s plans for Medicare-eligible retirees, will I loose eligibility to sign up for a Medigap plan in future years? I am very concerned with being required to undergo underwriting.


Thank you.

This CMS publication might answer your questions, "Medicare and Employer-Based Coverage":


http://www.medicarerights.org/PartB-...The-Basics.pdf