Swapping over to Medicare from the traditional employer health insurance plan can be a stressful transition. Most employers will only offer limited choices and those companies pay a large portion of those costs. When you swap over to Medicare, it’s easy to get overwhelmed by the sheer number of choices available. The prices can also be quite steep when compared to employer insurance. Those who go it alone usually end up overwhelmed and sometimes make the wrong choice.
Don’t panic! We’re here to help. Here are a few tips that will help you make this difficult transition
There is Not a Family Plan
Family plans do not exist in Medicare. While typical insurance covers you, your spouse, and your children, you will quickly learn that they will need to find an insurance plan of their own. You and your spouse will probably need different plans too since you probably have different needs.
Make sure that you understand both you and your spouse will have to sign up for Medicare when reaching 65 years of age. Of course, if your spouse still works at a job that has family coverage, then you might be able to stay on their plan until they retire.
Caps are Not Automatic
Caps on out-of-pocket expenses are not automatic. Most employer provided insurance comes with an annual limit on out-of-pocket healthcare expenses. On the other hand, Medicare will cover 80% of the costs but has no cap. It’s straight-up 80% from beginning to end.
This is not as bad as many people tend to think when they first see it. The major difference comes when an individual moves from a traditional employer plan to the Medicare Part D drug plan.
Strategically Schedule Certain Procedures
Yu should compare all of your expenses from your employer coverage with your new Medicare coverage to learn exactly what types of coverage you have. For instance, some people end up with much better hospitalization coverage with Medicare. This might cause you to look for a new place to get the next elective surgery.
On the other hand, if your employer provides really amazing coverage then you might want to get those elective procedures out of the way before moving over to Medicare.
Wellness Features are Likely Different
Wellness features are probably going to be much different when you swap over to your new Medicare plan. There are a ton of free wellness services offered by Medicare. Even though some traditional employer plans do offer wellness services, Medicare of usually superior on this regard. It’s usually designed to entice individuals to get their screenings in order to prevent health complications.
Medicare also tends to provide better coverage for in-person visits while commercial programs tend to lean more towards offering telephone advice. You should make sure that you compare both plans to see what new wellness services you have access to.
Swapping over to Medicare can be quite intimidating but hopefully you are better prepared now. Just remember that if you need help, then don’t be afraid to ask someone who has been through the process.
If for some reason your application is denied, here are some additional steps you can take.