presented by nea-nh · 2020. 9. 24. · jeff kantorowski. coordinator of benefit programs, nea nh....
TRANSCRIPT
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Retirement PlanningPresented by
NEA-NH&
NEA Member Benefits
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Medicare OverviewJeff Kantorowski
Coordinator of Benefit Programs, NEA [email protected]
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The Medicare Puzzle
Medi-gap Plans
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What is Medicare?• Federal health insurance program administered by the
Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).
• Your primary health insurance after:o You reach age 65 ando You retire and leave an employer-sponsored health plan
• Eligibility:o Must be eligible for Social Security (10 years working)o Must be 65+ (except disability)
• It is broken into four parts: A, B, C and D
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Parts A & B• Part A - Hospital Inpatient
o No premium cost for eligible participantso Covers most inpatient hospital expenseso Has a deductible
• Part B - Medical Serviceso 2020 standard monthly premium $144.60 (could be more
depending on income)o Covers 80% doctor bills & other outpatient medical expenses
after first $198 in approved charges (Part B deductible)
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Out-Of-pocket Exposure on Medicare A& B (Why you get a Supplement!)Part A: $1,408 deductible per benefit period in hospital• For hospital stays longer than 60 days:
o $352 per day from day 61-90o $704 per day after 90 days
Part B: $198 annual deductible, and• 20% of all medical costs after deductible• All medical costs while outside the U.S.
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Parts C & D• Part C – Medicare Advantage Plans
o Commercial health plans offered by Medicare-approved insurance companies
o Alternative HMO-type plan for Parts A & B, and in most plans, Part D
o ! Must receive services in a provider network
• Part D – Prescription Coverageo Covers a major portion of prescription drug costs o Out-of-pocket costs—monthly premiums, annual deductible and
prescription co-payments—will vary by plan o Enroll with a Medicare-approved prescription drug provider, not
Social Security
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Enrolling in Medicare• Initial Enrollment Period, typically at age 65.
o If still working and covered by employer plan, only enroll in Part A at no cost
o 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.
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Other Medigap Plan Options
• If not eligible for employer Medigap plan, or too costly
• Options: NEA Member Benefits, AARP, Humana, Anthem, medicare.gov
• 12 standard plans*, “A” to “N” with various benefits and premium costs
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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
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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
Keep
SC65+ /MC3
Shop for Part D
Rxcoverage
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Source: Segal Consulting
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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.
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Monthly Cost (Per individual)
Part A Part B Medi-gapSupplement
Monthly Premium $0.00 $144.60 Approx. $296* -$600 (with Rx)
*SchoolCare 65+ Plan G with Rx
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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),[email protected]
Retirement Planning�Presented by�NEA-NH �& �NEA Member BenefitsMedicare OverviewThe Medicare PuzzleWhat is Medicare?Parts A & BOut-Of-pocket Exposure on Medicare A& B (Why you get a Supplement!)Parts C & DEnrolling in MedicareMedigap PlansOther Medigap Plan OptionsSlide Number 11Part D RxPart D Rx “Carve Out”Slide Number 14SpousesMonthly Cost (Per individual) Resources For More Info