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Retirement PlanningPresented by
NEA-NH&
NEA Member Benefits
neanh.org/retirement-seminars/
Medicare OverviewJeff KantorowskiCoordinator of Benefit Programs, NEA [email protected]
The Medicare Puzzle
Medi-gap Plans
What is Medicare?
• Federal health insurance program administered by Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (DHHS).
• Your primary health insurance after:• You reach age 65 and• You retire and leave an employer-sponsored
health plan
• Eligibility:• Must be eligible for Social Security (10 years working)
• Must be 65+ (except disability)
• It has four parts: A, B, C and D
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Parts A & B
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Part A - Hospital Inpatient
-No premium cost for eligible participants
-Covers most inpatient hospital expenses
-Has a deductible out-of-pocket
Part B – Medical Outpatient Services
-2021 standard monthly premium $148.50 (could be more depending on income)
-Covers 80% doctor bills & other outpatient medical expenses after first $203 in approved charges (Part B deductible)
Parts C & D
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Part C – Medicare Advantage Plans
-Commercial health plans offered by Medicare-approved insurance companies -Alternative HMO-type plan for Parts A & B, and in most plans, Part D-! Must receive services in a provider network
Part D – Prescription Drug Plans
-Covers a major portion of prescription drug costs -Out-of-pocket costs- monthly premiums, annual deductible and prescription co-payments- will vary by plan -Enroll with a Medicare-approved prescription drug provider, not Social Security
Out-Of-pocket Exposure on Medicare A& B
• For hospital stays longer than 60 days:• $371 per day from day 61-90• $742 per day after 90 days
Part A: $1,484 deductible per benefit period in hospital
• 20% of all medical costs after deductible• All medical costs while outside the U.S.
Part B: $203 annual deductible, and
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!Note: a Medicare Supplement plan covers most of the above out of pocket.
Enrolling in Medicare
• Initial Enrollment Period, typically at age 65.• If still working and covered by employer plan, only enroll in
Part A at no cost• If spouse is still working and has employer insurance, only
enroll in Part A
• When retired and over age 65, enroll in full Medicare: Part B and supplement and Part D Rx coverage.
• Penalties apply if you wait and don’t enroll when you should.
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Medigap Plans
• Optional supplement plans to fill in Medicare gaps in coverage and costs.
• Additional monthly premium. • Available through your employer: i.e.
Medicomp III, SchoolCare 65+ • Prescription drug coverage included or,
find alternative Rx plan.• Enroll through employer upon turning age
65 and retired with Medicare as primary.
Other Medigap Plan Options
• If not eligible for employer Medigap plan, or too costly
• Options: NEA Member Benefits, AARP, Humana, Anthem, medicare.gov, etc
• 12 standard plans, “A” to “N” with various benefits and premium costs
Part D Rx• Prescription drug coverage• Some employer Medicare Supplement plans offer Rx coverage built-in
(SchoolCare 65+ / HealthTrust Medicomp 3)
A & B Medical Supplement
SchoolCare 65+ orHealth Trust Medicomp 3
Rx Supplement
Part D Rx “Carve Out”• SchoolCare and HealthTrust allow “carve out” of the Rx benefit and just
take the medical supplement.• Shop for a separate Part D plan from another carrier (i.e.: AARP, Express
Scripts etc)• Costs vary widely depending on the plan
SC65+ /MC3
Shop for Part D
Rxcoverage
Keep
Source: Segal Consulting
2021
$445
$4,130
$6,550
Spouses
• Spouses can be covered by the school district medical plans.
• Couples will have individual plans depending on ages.
• Spouses can obtain Medicare supplements from school districts and NEA Member Benefits.
Monthly Cost (Per individual)
• *SchoolCare 65+ Plan G with Rx
Part A Part B Medi-gapSupplement
Monthly Premium
$0.00 $148.50 Approx. $296* -$600 (with Rx)
Resources For More Info
• Your employer SAU office- HR / benefits• http://www.nh.gov/insurance/consumers/medicare.htm• www.medicare.gov • Medicare And You publication available online• NH Service Link: www.nh.gov/servicelink• NEA Member Benefits: www.neamb.com• NEA NH: 603-224-7751 (Jeff Kantorowski),
