When your spouse retires and gets Medicare, they (and you) will lose their work health insurance.
For example, Sylvia is 63 years old. Her husband Mike is 65. Mike is about to retire and will soon receive Medicare benefits. They will lose Mike’s employment group insurance (a benefit they’ve both enjoyed for decades). Sylvia will not be eligible for Medicare coverage for another two years. For the first time, she will be without health coverage.
NOTE: Medicare does not cover family members. Your spouse will apply for Medicare benefits at retirement age. Once you are eligible to receive benefits, you will apply separately to your spouse.
Here are some things to consider as you start the process of getting coverage until you age into Medicare.
Start with your health care needs
Unlike the group coverage you accessed through your spouse’s employment, this insurance is solely for you! Before you speak with your plan specialist, take a moment to evaluate your healthcare needs and preferences:
1) How often do you go to the doctor?
It could be that since you last updated your insurance, your health needs have changed. Maybe your visits to the doctor are less frequent. Perhaps you have health concerns you’d like to give more attention to (e.g., skin health and nutrition counseling).
Also, think about your dental and prescription needs. Did your dentist create a long-term treatment plan that may exceed your current insurance’s expiration? Without coverage, what are the possible costs for your medications?
2) How important is it that you keep your existing health care provider?
If you have a close relationship with your physician and want to continue with them, that will be an important consideration when choosing a new plan. Generally, an in-network physician will be more cost-effective than choosing to go out of network.
3) Do you want coverage only until you’re Medicare eligible?
Depending on your needs and preferences, you may want a plan to get you through the period between losing your spouse’s work coverage and getting your Medicare benefits. As you explore your options, keep in mind the coverage you’ve had until now—what you like and don’t like and the coverage that’s important to you.
Know your healthcare budget
As your spouse heads into retirement, your household income level will probably change. As you explore coverage to carry you through to your retirement, take into consideration your budget and how much you want to apply to deductibles and monthly premium costs.
Having a cost range in mind will make the process of choosing a pre-Medicare plan more straightforward.
For example, depending on your income level, you may qualify for financial assistance through your state or the Federal government.
If you don’t qualify for assistance, your plan specialist will help you find coverage to fit your budget and health needs.
Also, you may qualify for COBRA (Consolidated Omnibus Budget Reconciliation Act). This plan allows you to keep your group health coverage for up to 18 months after retirement. However, COBRA tends to be expensive, as most employers don’t subsidize the plan. The beneficiary must cover that additional cost.
Once your spouse retires and gets Medicare, you’ll need to find your own coverage
As you prepare for your spouse’s retirement, you’ll be navigating new territory. You’ll have to adjust to changes in income, your spouse’s leisure time, and your health insurance.
Take the opportunity to explore your previous coverage, as well as your care preferences, your health status, and financial needs. The more you prepare now, the easier the transition to retirement, signing up for Medicare, and for you—getting pre-Medicare coverage—will be!
Source: My Senior Health Plan