How does my group health plan coverage work after I retire? It depends on the terms of your specific plan. Your employer or union or your spouse’s employer or union might not offer any health coverage after you retire. If you can get group health plan coverage after you retire, it might have different rules and might not work the same way with Medicare.

 

Can I continue my employer coverage after I retire? Generally, when you have retiree coverage from an employer or union, they manage this coverage. Employers aren’t required to provide retiree coverage, and they can change benefits or premiums, or even cancel coverage.

 

What are the price and benefits of the retiree coverage, and does it include coverage for my spouse? Your employer or union may offer retiree coverage that limits how much it will pay. It might only provide "stop loss" coverage, which starts paying your out-of-pocket costs only when they reach a maximum amount.

 

What happens to my retiree coverage when I’m eligible for Medicare? If your former employer offers retiree coverage, the coverage might not pay your medical costs during any period in which you were eligible for Medicare but didn’t sign up for it. When you become eligible for Medicare, you may need to join both Medicare Part A and Medicare Part B to get full benefits from your retiree coverage.

 

What effect will my continued coverage as a retiree have on both my health coverage and my spouse’s health coverage? If you’re not sure how your retiree coverage works with Medicare, get a copy of your plan’s benefit materials, or look at the summary plan description provided by your employer or union. You can also call your employer’s benefits administrator and ask how the plan pays when you have Medicare.

 

How does retiree coverage compare with a Medicare Supplement Insurance (Medigap) policy? Since Medicare pays first after you retire, your retiree coverage is likely to be similar to coverage under a Medigap policy. Retiree coverage isn’t the same thing as a Medigap policy but, like a Medigap policy, it usually offers benefits that fill in some of Medicare’s gaps in coverage, such as coinsurance and deductibles. Sometimes retiree coverage includes extra benefits, like coverage for extra days in the hospital.

 

If I choose to buy a Medigap policy, when should I buy it? The best time is during your 6-month Medigap Open Enrollment period, because you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you’re 65 and enrolled in Part B, and once it’s over, you can’t get it again.

 

Remember: You and your spouse would each have to buy your own Medigap policy, and you can only buy a policy when you’re eligible for Medicare.

 

I’m retired and have Medicare.I also have group health plan coverage from my own former employer.Who pays first? Generally, Medicare pays first for your health care bills and your group health plan (retiree) coverage pays second.

 

I’m retired and have Medicare.My spouse is still working and I have group health plan coverage through my spouse’s employer.Who pays first? If your spouse’s employer has 20 or more employees, your spouse’s coverage pays first and Medicare pays second. If your spouse’s employer has less than 20 employees, Medicare pays first.

 

What happens if I have group health plan coverage after I retire and my former employer goes bankrupt or out of business? If your former employer goes bankrupt or out of business, federal COBRA rules may protect you if any other company within the same corporate organization still offers a group health plan to its employees. That plan is required to offer you COBRA continuation coverage.  If you can’t get COBRA continuation coverage, you may have the right to buy a Medigap policy even if you’re no longer in your Medigap Open Enrollment Period.

 

 

Source of information: www.Medicare.gov