INDUSTRY INSIGHT
RETIREMENT HEALTH INSURANCE
SPONSORED CONTENT
PLANNING FOR RETIREMENT ?
Health insurance seems to be a confusing topic for a lot of people . Here are a few tips to make sure you know how to choose the best plan for you and your family members .
ELIGIBILITY Medicare – Individuals must be 65 years old or on Social Security Disability Insurance ( SSDI ) for 24 months , or diagnosed with End Stage Renal Disease or ALS .
Individuals under 65 – Shop for individual plans from carriers or on Pennie . com for premium tax credits .
MEDICARE COSTS Part A ( Hospital )
$ 0 premium as long as you / spouse worked for 10 years .
Part B ( Outpatient )
$ 174.70 / month , unless your adjusted gross income is greater than $ 103,000 for individuals and $ 206,000 for joint filers . For individuals with limited savings whose monthly income is below $ 1,695 , or $ 2,300 for married couples , the state pays Part B premium .
Part C ( Medicare Advantage )
Costs vary , from $ 0- $ 200 +/ month . Part A & Part B ( and usually Part D ) benefits come through an insurance carrier . Plans include extra benefits such as dental , vision , hearing aids , gym memberships , overthe-counter allowance and more .
Part D ( Prescription Drug Plans )
Costs vary . Similar to Part B , individuals with higher incomes pay higher monthly premiums . Individuals with monthly incomes less than $ 1,883 , or married couples less than $ 2,555 , are eligible for Extra Help . This Low Income Subsidy ( LIS ) helps pay for drug plan premiums and copays .
CONSIDERATIONS / QUESTIONS Turning 65 ? If you ’ re covered by your / spouse ’ s employer plan and the employer has more than 20 full-time employees , you don ’ t need to enroll in Medicare Part A or Part B .
Contributing to a Health Savings Account ? You can ’ t be enrolled in Medicare Part A or Part B .
Medicare Supplement with Part D plan vs . Medicare Advantage – Everyone ’ s situation is different and there are tradeoffs for both types of plans .
Network – Check hospitals , doctors , preferred pharmacies , physical therapists , durable medical equipment , etc .
Formulary – There is a list of prescriptions by drug tier . Medicare . gov ’ s plan finder ( medicare . gov / plan-compare ) allows users to enter prescriptions , dosages and quantities . All Part D or Medicare Advantage Prescription Drug Plans in the county will calculate premiums and drug copays , and the most cost-effective plan sorts to the top .
Costs – Multiply the monthly premium by 12 . This is the cost of the plan for the year .
Extra benefits – Plans are offering thousands of dollars in dental , vision , over-the-counter medications , transportation , utility allowances , healthy food debit cards and more .
Out-of-pocket maximum – This is the dollar amount that limits your total out-of-pocket costs for medical costs such as copays , deductibles and coinsurance .
Erin Hagan Hart is an independent licensed insurance agent specializing in health insurance options for individuals and retirees . She ’ s worked in the health care industry in Western PA since 1994 . Erin sells Medicare Supplement , Medicare Advantage , and Part D Prescription Drug Plans and she ’ s contracted with AARP United Healthcare , Aetna , Cigna , Highmark Blue Cross Blue Shield , Highmark Wholecare , Humana , Silverscript , UPMC for Life and Wellcare . She sells plans for individuals on Pennie . com , Highmark Blue Cross Blue Shield and UPMC Health Plan . Erin can be reached at ehart @ american-healthcare . net or 412.657.3028 .
MT . LEBANON ❘ SUMMER 2024 9