Americans are staying in the work force longer and more people aged 65 and older who recently saw their nest egg shrink are returning to work after a period of retirement. As these trends grow, more people find themselves in the position of coordinating Medicare benefits and employer-sponsored health plans.

Double eligibility

Older workers can be eligible for both Medicare Part B, which helps pay for doctors’ services, outpatient hospital care, and some other medical services not covered by Medicare Part A, and a group health insurance plan offered through an employer. If you find yourself dually eligible, which plan do you choose and how do Medicare and private insurance work together if you choose both?

If your employer is offering group insurance, check to see whether the group plan or Medicare is the better value. To do so, look beyond the monthly premium. In particular, examine closely how your employer’s plan compares with Medicare coverage taking your unique medical and prescription needs into consideration. What ends up being a good plan for one person is not necessarily comprehensive enough for another.

What you should know

If you decide to keep both Medicare and group coverage, you should be prepared for a complicated set of rules regarding who covers what. A good resource to help you sort it all out can be found in the Medicare guidelines. You can also talk with your group plan’s administrator about your private benefits and how they impact and coordinate with Medicare Part B.

Money matters

If you’ve been receiving Medicare benefits and have recently gone back to work, check to see how your income will affect your premiums. Most people pay the standard Part B premium of $96.40 per month (these are 2009 rates, which may change in 2010). If you are an individual making more than $85,000, or a married couple with an annual income that exceeds $170,000, your premium will be higher. You can check here to see a chart of premiums by income level.

If you don’t yet have Medicare, but are nearing 65, you can choose to delay your Medicare Part B enrollment if you or your spouse is working and have group health insurance. Normally, delaying Part B enrollment when you first become eligible (you can sign up anytime during a 7-month period that begins 3 months before you turn 65) can increase the cost as much as 10% for each 12-month period you didn’t sign up but were eligible. You pay this penalty for as long as you have Medicare Part B.

Of course, it may be that Medicare alone is a better value for you than the private insurance. You can choose Medicare if you continue to work, bypassing your employer’s health insurance offering all together.

Johnny come lately

If you put off signing up for Medicare Part B and then later decide that you want the benefit, you can sign yourself up during a special enrollment period. Here’s what constitutes a special enrollment period:

• Anytime you are still covered by your and your spouse’s employer’s health plan
• The eight month period following the month your employer’s group health plan coverage ends
• When your employment ends.

If you miss your opportunity during the special enrollment period your next opportunity to sign up is during the next general enrollment period, which is January 1 through March 31 of each year. Coverage will start on July 1st of the year you sign up.
Call Social Security at 1-800-772-1213 or you can contact your local Social Security office to sign up.

Check here to find the office closest to you.

Good luck!

Tags: age 65, employer-sponsored health plans, medicare, medicare part a, medicare part b, older workers, SDNN

This entry was posted on Friday, July 17th, 2009 at 4:14 pm and is filed under Business, Giving’em the Business. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.