Page 25 - Leisure Living

Are You On Medicare And Insured On
Your Employer’s Health Plan? You May
Be Making A Costly Mistake
By Steve Gulas, Bolte Insurance, www.bolteinsurance.com
Each year I come across many people who are able to get Medicare Part A and B but are either still working for their employer, or retired and taking their medical benefits through their former employer. After showing many of these people private health insurance options they are able to purchase outside of their employer’s plan, many are surprised that many times they can find more benefit rich plans with lower premiums in a private plan.
Failing to evaluate your options is a mistake that could cost you thousands of dollars in extra premiums and out of pocket medical costs.
Why is this so? There are two reasons you may be better off not being on your employer sponsored health plan.
1. Medicare is heavily subsidized by the government. If your employer does not require you to be enrolled in Medicare Part B you may save paying this premium to Medicare. However, your employer may be passing this cost on to you, as they have to pick up the entire cost of these medical services without the help of Medicare. In the end this may be costing you extra money.
2. Not too many years ago, before affordable prescription drug coverage was available through Medicare, it almost always made sense to stay on your employer’s plan in order to get the prescription drug coverage, as it was not available through Medicare. Since Medicare Part D and Part C became available in 2006, staying on your employer’s plan may no longer be your best option. Many more affordable Medicare Options have become available, providing both Medical and Drug coverage through Medicare Part C and D that provide affordable prescription drug coverage.
Things to consider to determine whether you are better off on your employer sponsored plan or on a private plan.
1. Will you have to enroll in Medicare Part B if you leave your employer’s plan?
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2. Evaluate your prescription drug utilization and see how the Medicare Part D “Coverage Gap” may or may not impact your out of pocket drug costs.
3. Evaluate the total of premiums you will be paying in each situation?
4. Is there a network of doctors and hospitals you are required to use? Most employer sponsored plans are PPO or HMO plans in which you may be required to receive treatment from a contracted provider. Most Medicare supplemental plans have no provider network. This may benefit you because you no longer have to worry if your doctor or hospital is in the plan network. It gives you more flexibility as to where you may receive medical services.
5. Can you get back on your employer-sponsored plan if you leave? Some company plans allow you to do so, however it is more common that you cannot.
This is typically not an easy thing to evaluate as there are many factors to consider. Like many decisions in life there are pros and cons to each that need to be carefully evaluated. If you need help in evaluating your situation to determine what might make the most sense, local people with knowledge of Medicare plans are available to help. Ifyouwouldliketoevaluateyoursituation please contact Steve Gulas or Chuck Devore with Bolte Insurance Agency at 419-732-3111.
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July 2015 LeisureLiving | 25