Medicare Options For The Active Employees Over Age 65 And Retirees

The retiring employee is eligible for Medicare but often does not understand the different plans available under Medicare, and turn to HR for help. HR, in most instances, also is not knowledgeable in this area unless they have a retiree program, which is not typical for most U.S. employers. In addition, active employees over age 65 are eligible for Medicare and need assistance understanding the rules surrounding Medicare eligibility for active employees.

The discussion would focus on the following:

1). MSP rules – Medicare Secondary Payor Rules explaining when Medicare is secondary to group health plans for active employees or former disabled employees
2). For active employees over age 65 that remain covered by the group health plan and do not sign up for Medicare Part B or D when first eligible, the post employment Medicare enrollment period available to them to avoid late enrollment penalties.
3). For active employees that have Medicare as their primary insurance provider and for retiring employees, a description of the plans available under Medicare: Original Medicare, Medicare Advantage HMO plans and Medicare Advantage PPO plans.
4). For those choosing Original Medicare, an explanation of Medigap policies which are usually purchased to cover the out of pocket costs (deductible/co-insurance) not covered by Medicare.
5). In addition, it is essential for Medicare eligible individuals to carefully choose their Medicare Prescription Drug plan (PDP). Each PDP has a prescription drug formulary list at various tier levels. Certain prescriptions may be covered by one carrier and not at all by another, or one carrier may have a managed care provision applicable to the drug (such as a quantity limit) while another may not have any limitations. It is also important to calculate the annual costs of the prescription drugs determine if coverage should be purchased during the “donut hole” or coverage gap that occurs with all Medicare Prescription drug plans.
6). Medicare Creditable Coverage letters that must be provided to employees at specified times during the year.

All Human Resource Professionals will find this seminar valuable because when employees retiree they are often turn to HR with questions regarding Medicare. For companies that do not have retiree plans, this is an area of unchartered territory for Human Resources. For those that do have retiree plans, this seminar will be a refresher course covering the various facets of Medicare.

1). Medicare Secondary Payor Rules: Participants will learn who pays first – Medicare or a Group Health Plan- for active employees over the age of 65 as well as for disabled employees under the age of 65 eligible for Medicare 2). Participants will learn the difference between Original Medicare and Medicare Advantage Plans 3). Participants will learn about Medicare Prescription Drug plans, the coverage gap, and how to choose a PDP.

www.medicare.gov Medicare & You 2012 Manual

		Carol Renzi Strategic Benefit Solutions, Inc. View Profile