Medicare & Retiree Benefits: What You Need to Know

What Are Retiree Health Benefits?

Retiree health benefits are employer-sponsored insurance plans that continue after retirement, often providing:

• Medicare Supplement (Medigap) or Medicare Advantage coverage
• Prescription drug benefits
• Lower maximum-out-of-pocket and co-pays compared to open-market plans
• Additional dental, vision, or hearing benefits

These benefits are often more comprehensive or cost-effective than individual Medicare plans. Before making any changes, you must confirm what your employer-provided benefits include.

Can You Switch from a Retiree Plan to a Traditional Medicare Plan?

In some cases, switching from an employer-provided retiree plan to a traditional Medicare plan on the open market may be a better option. However, it’s important to review the trade-offs carefully.

When Staying on a Retiree Plan May Be Best:

• Your employer pays part or all of your premiums.
• The plan offers lower co-pays and Maximum-Out-Of-Pocket (MOOP) costs than open-market Medicare options.

When Switching to an Open-Market Medicare Plan May Be Worth Considering:

• Your employer no longer contributes to premiums, making the plan more expensive.
• The plan has limited doctor networks, and you want more provider flexibility.
• You are paying higher out-of-pocket costs than you would with a Medicare Advantage or Medigap plan.

Compare Retiree Benefits vs. Open Market Medicare Plans

Employer-Sponsored Health Plans & Restrictions

Some retiree benefits require you to use a specific Medicare brokerage to maintain coverage. If your plan has this restriction, we cannot assist you, as enrolling through us could cause you to lose the benefits you’ve worked hard for.

If you’re unsure about your options, we offer a free 15-minute consultation to help you determine whether:

• Staying with your retiree plan is the best option.
• Transitioning to a Medicare Advantage or Medigap plan on the open market would offer better coverage and savings.

Tip: Have your Summary of Benefits ready so we can make an accurate comparison.

Schedule a Free Retiree Benefits Review

Common Myths About Retiree Medicare Benefits

• “I have retiree benefits, so I don’t need to enroll in Medicare.”
  • Most retiree plans require you to enroll in Medicare Parts A & B first before the employer coverage begins.
• “Medicare Advantage and Medigap plans are always better than retiree plans.”
  • Employer-sponsored plans often provide better coverage at a lower cost, but this varies by plan.
• “I can switch out of my retiree plan and go back later if I change my mind.”
  • In most cases, once you leave an employer-sponsored retiree plan, you cannot re-enroll. Check with your HR or Benefits department before making any changes.

Making the Right Decision for Your Retirement Healthcare

Every retiree’s healthcare needs are different. Before making changes to your plan, schedule a free review with our team.

We will help you:

• Understand your retiree health benefits and how they compare to Medicare plans.
• Determine whether switching to an open-market plan is beneficial or not.
• Ensure you don’t lose valuable coverage by making the wrong choice.

Schedule a Free Retiree Benefits Consultation