Health Insurance in Retirement
Few retirees have the desire or the resources to foot the bill for their health care on their own. Fortunately, most American retirees don't have to. They are covered by Medicare, a federal program that is the primary source of health insurance for individuals age 65 and older.
However, you generally can't rely on Medicare to pay all of your health costs in retirement. Medicare doesn't cover everything, and you'll have to satisfy a deductible and make co-payments for some types of care. For this reason, you may want to look into buying a Medigap policy designed to supplement Medicare coverage. Or, if you're worried about needing nursing home care in the future, you may want to look into buying a long-term care insurance policy, especially if you don't want to rely on Medicaid to pay for possible nursing home bills.
Your changing health insurance needs in
retirement
Your need for health insurance
won't automatically increase after you retire, but it will
change. It's wise to be prepared. Here are some of the ways
your health insurance may be affected after you retire:
Your health-care costs may rise
Although you may remain quite healthy, you may find that you
need to visit your doctor more frequently as you grow older.
You also may need to take more prescription medications and
require more extensive treatment than you did when you were
younger.
Your employer-sponsored health
insurance coverage may end
Retirement may spell the end of your employer-sponsored
health insurance. Generous employers may offer extensive
health insurance coverage to their retiring employees, but
this is the exception rather than the rule. If you are 65 or
older when you retire, you don't have much to worry
about--you'll automatically become eligible for Medicare
benefits upon your 65th birthday. But if you retire before
age 65, you'll need some way to pay for your health care if
your employer doesn't extend health benefits to you. You may
want to consider buying a private health insurance policy or
extend your employer-sponsored coverage through COBRA.
You may become entitled to Medicare and
other government benefits
Several government programs exist that can help you pay for
health care in retirement. These programs include Medicare,
Medicaid, and certain military benefit programs that aid
retired service-members.
Medicare
As mentioned, most Americans automatically become entitled
to Medicare when they turn 65. In fact, if you're already
receiving Social Security benefits, you won't even have to
apply--you'll be automatically enrolled in Medicare.
However, you will have to decide whether you only need Part
A coverage, which is free, or if you want to pay the premium
for Part B coverage. Part A covers home health care, hospice
care, and services associated with inpatient hospital care.
Part B covers other medical care such as physician care,
laboratory tests and physical therapy. You may also choose
to enroll in a managed care plan under Medicare Part C if
you want to pay fewer out-of-pocket health-care costs.
Medicaid
If you are aged, disabled, or blind and can't afford medical
care, Medicaid may pay for your hospital and doctor bills,
among other things. Approximately 38 million people receive
Medicaid benefits, including over 60 percent of all nursing
home residents. However, there are many rules for using
Medicaid to pay for nursing home care. Check with a
financial planner or an attorney experienced in Medicaid
planning before relying on Medicaid to pay for long-term
care.
Medigap
Medigap is supplemental insurance specifically designed to
cover some of the gaps in Medicare coverage. Although the
name might lead you to believe otherwise, Medigap is
provided by private health insurance companies, not the
government. Federal and state governments do strictly
regulate Medigap, however.
Unless you can afford to pay for the things Medicare doesn't
cover (e.g., prescription drugs), as well as annual
co-payments and deductibles that apply to certain types of
care, you may want to buy some type of Medigap policy when
you sign up for Medicare Part B. There are 10 standard
Medigap policies that you can purchase. Each of these
policies offers certain basic core benefits, and all but the
most basic policy (Plan A) offer various combinations of
additional benefits designed to cover what Medicare does
not. Although not all Medigap plans are available in every
state, you should be able to find a plan that best meets
your needs and your budget.
Military benefits
Health care for veterans is typically available at VA
hospitals and health-care facilities. In general, active
duty service-members, retirees, and veterans other than
those who were dishonorably discharged are eligible for
military benefits. Survivors of service-members and veterans
are also eligible for some of the same benefits. However,
the rules surrounding these benefits can be complex and may
change frequently. It's best to check with your local VA
office if you have questions about your health-care benefits
in retirement.
You may need long-term care
The possibility of a prolonged stay in a nursing home weighs
heavily on the minds of many older Americans and their
families. This is hardly surprising, considering that the
annual cost of nursing home care in most facilities is more
than most people's annual salary. There are several
resources you can use in planning for this potential
expense, including self-insurance, Medicare (limited
benefits), Medicaid, and military benefits. You might also
consider purchasing separate long-term care insurance, which
is designed specifically for this purpose, especially since
private health insurance generally doesn't cover nursing
home care.
Please Note: The information contained in this Web site is provided solely as a source of general information and resource. It is a not a statement of contract and coverage may not apply in all areas or circumstances. For a complete description of coverages, always read the insurance policy, including all endorsements.