When thinking about retiring, Medicare is an important part of that decision. Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too.
The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have Original Medicare (Part A and Part B) coverage, you can buy a Medicare Supplement Insurance (Medigap) policy from a private insurance company.
Employees who are eligible for the Retiree Health Benefit can be reimbursed by the college for the costs of Medicare Part B and a Supplement plan.
Parts of Medicare
Social Security enrolls you in Original Medicare (Part A and Part B).
- Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay). Part A also pays for some home health care and hospice care.
- Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental (Medigap) policies help pay Medicare out-of-pocket copayment, coinsurance, and deductible expenses.
- Medicare Advantage Plan (previously known as Part C) includes all benefits and services covered under Part A and Part B — prescription drugs and additional benefits such as vision, hearing, and dental — bundled together in one plan.
- Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medical hospital insurance (Part A) if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance (Part B) by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read Medicare Premiums: Rules For Higher-Income Beneficiaries.
Enrollment Periods
If you’re eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.
You can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance). Because you must pay a premium for Part B coverage, you can turn it down.
If you choose not to enroll in Medicare Part B at that time and then decide to do so later, your coverage could be delayed and you may have to pay a higher monthly premium for as long as you have Part B. Your monthly premium will go up 10 percent for each 12-month period you were eligible for Part B, but didn’t sign up for it, unless you qualify for a “Special Enrollment Period”. Continuing to work for the college and being covered under the college’s group insurance DOES qualify you for a Special Enrollment Period. This rule also applies to a spouse who is covered under the college’s plans. For more information see: Special Enrollment Period. A form will be filled out by the HR department for you that verifies your coverage.
Supplemental (Medigap) Plan
Medicare Parts A & B cover about 80% of your costs and a Supplemental plan can help to cover the remaining 20%. There are numerous options available and the college sponsors a plan through MountainOne Insurance. There is a time requirement for signing up for the college’s plan around the date of your retirement so it is best to reach out to them during your planning process. Please contact:
Linda Grande
413-663-2384
[email protected]
www.mountainone.com/insurance/medicare
Confused about everything related to Medicare? MountainOne can also help explain each part and the process of signing up as well as help you search for Supplemental or Advantage plans.
Download and watch this 17 min. presentation created by MountainOne – Preparing for Medicare. The slides referenced in the presentation can be downloaded as well – Preparing for Medicare Slides. (clicking the links should start a download of the files)
Ready to Sign Up?
Visit the Social Security Administration’s website to start your Medicare enrollment and/or your Social Security Retirement Benefits.
Other Resources
Local Social Security Office
96 Marshall St.
North Adams, MA 01247
Phone: 877-319-5709
Fax: 833-950-3260
Website: www.ssa.gov
Download a condensed booklet about Medicare from the Social Security website. (clicking the link should start a download of the file)
Download the Medicare and You Handbook from the U.S. Government.
Ecu-Health Care
99 Hospital Ave. Suite 208
North Adams, MA 01247
Phone: 413-663-8711
Website: ecuhealthcarena.com
Ecu-Health Care helps the uninsured and underinsured residents of North Berkshire County access affordable health care. They have trained SHINE counselors on staff, helping elders understand their health benefits and making sure they access all available health care programs they are eligible for. They also help explain and enroll individuals in Medicare Part D, the prescription drug coverage and can provide information on Medicare premium payment assistance programs.
SHINE (Serving Health Insurance Needs of Everyone)
Elder Services of Berkshire County
877 South St. Suite 4E
Pittsfield, MA 01201
Phone: 413-499-0524
Website: www.esbci.org/programs_and_services/shine.html
SHINE counselors provide information and assistance with all parts of Medicare. More information about SHINE counselors can be found on their website as well as additional locations throughout Berkshire County to speak with a counselor.
TIAA Counseling Sessions
Speak with a TIAA representative about your retirement account and distribution options.