Retirement PlanningPresented by

NEA-NH&

NEA Member Benefits

Medicare OverviewJeff Kantorowski

Coordinator of Benefit Programs, NEA NHjkantorowski@nhnea.org

The Medicare Puzzle

Medi-gap Plans

What is Medicare?• Federal health insurance program administered by the

Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).

• Your primary health insurance after:o You reach age 65 ando You retire and leave an employer-sponsored health plan

• Eligibility:o Must be eligible for Social Security (10 years working)o Must be 65+ (except disability)

• It is broken into four parts: A, B, C and D

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Parts A & B• Part A - Hospital Inpatient

o No premium cost for eligible participantso Covers most inpatient hospital expenseso Has a deductible

• Part B - Medical Serviceso 2020 standard monthly premium $144.60 (could be more

depending on income)o Covers 80% doctor bills & other outpatient medical expenses

after first $198 in approved charges (Part B deductible)

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Out-Of-pocket Exposure on Medicare A& B (Why you get a Supplement!)Part A: $1,408 deductible per benefit period in hospital• For hospital stays longer than 60 days:

o $352 per day from day 61-90o $704 per day after 90 days

Part B: $198 annual deductible, and• 20% of all medical costs after deductible• All medical costs while outside the U.S.

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Parts C & D• Part C – Medicare Advantage Plans

o Commercial health plans offered by Medicare-approved insurance companies

o Alternative HMO-type plan for Parts A & B, and in most plans, Part D

o ! Must receive services in a provider network

• Part D – Prescription Coverageo Covers a major portion of prescription drug costs o Out-of-pocket costs—monthly premiums, annual deductible and

prescription co-payments—will vary by plan o Enroll with a Medicare-approved prescription drug provider, not

Social Security

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Enrolling in Medicare• Initial Enrollment Period, typically at age 65.

o If still working and covered by employer plan, only enroll in Part A at no cost

o If spouse is still working and has employer insurance, only enroll in Part A

• When retired and over age 65, enroll in full Medicare: Part B and supplement and Part D Rx coverage.

• Penalties apply if you wait and don’t enroll when you should.

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Medigap Plans• Optional supplement plans to fill in Medicare gaps in

coverage and costs.• Additional monthly premium. • Available through your employer: i.e.

Medicomp III, SchoolCare 65+ • Prescription drug coverage included or, find alternative

Rx plan.• Enroll through employer upon turning age 65 and retired

with Medicare as primary.

Other Medigap Plan Options

• If not eligible for employer Medigap plan, or too costly

• Options: NEA Member Benefits, AARP, Humana, Anthem, medicare.gov

• 12 standard plans*, “A” to “N” with various benefits and premium costs

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Part D Rx• Prescription drug coverage• Some employer Medicare Supplement plans offer Rx

coverage built in (SchoolCare 65+ / HealthTrust Medicomp 3)

A & B Medical

Supplement

SchoolCare 65+ orHealth Trust Medicomp 3

Rx Supplement

Part D Rx “Carve Out”• SchoolCare and HealthTrust allow “carve out” of the

Rx benefit and just take the medical supplement.• Shop for a separate Part D plan from another carrier

(i.e.: AARP, Express Scripts etc)• Costs vary widely depending on the plan

Keep

SC65+ /MC3

Shop for Part D

Rxcoverage

Source: Segal Consulting

Spouses

• Spouses can be covered by the school district medical plans.

• Couples will have individual plans depending on ages.

• Spouses can obtain Medicare supplements from school districts and NEA Member Benefits.

Monthly Cost (Per individual)

Part A Part B Medi-gapSupplement

Monthly Premium $0.00 $144.60 Approx. $296* -$600 (with Rx)

*SchoolCare 65+ Plan G with Rx

Resources For More Info• Your employer SAU office- HR / benefits

• http://www.nh.gov/insurance/consumers/medicare.htm

• www.medicare.gov

• Medicare And You publication available online

• NH Service Link: www.nh.gov/servicelink

• NEA Member Benefits: www.neamb.com

• NEA NH: 603-224-7751 (Jeff Kantorowski),jkantorowski@nhnea.org

Retirement Planning�Presented by�NEA-NH �& �NEA Member BenefitsMedicare OverviewThe Medicare PuzzleWhat is Medicare?Parts A & BOut-Of-pocket Exposure on Medicare A& B (Why you get a Supplement!)Parts C & DEnrolling in MedicareMedigap PlansOther Medigap Plan OptionsSlide Number 11Part D RxPart D Rx “Carve Out”Slide Number 14SpousesMonthly Cost (Per individual) Resources For More Info