If you’re retired and have
(retiree) coverage from a former employer, generally Medicare pays first for your health care bills, and your
coverage pays second.
4 things to find out about your retiree coverage
- Can you continue your employer coverage after you retire? Generally, when you have retiree coverage from an employer or union, they control this coverage. Employers aren’t required to provide retiree coverage, and they can change benefits, premiums, or even cancel coverage.
- What’s the cost and coverage? Your employer or union may offer retiree coverage for you and/or your spouse that limits how much it will pay. It might only provide “stop loss” coverage, which starts paying your out-of-pocket costs only when they reach a maximum amount.
- What happens to your retiree coverage when you’re eligible for Medicare? Retiree coverage might not pay your medical costs during any period in which you were eligible for Medicare but didn’t sign up for it. When you become eligible for Medicare, you will need to enroll in both Medicare Part A and Part B to get full benefits from your retiree coverage.
- How does your retiree coverage work with Medicare? Get a copy of your plan’s benefit booklet, look at the summary plan description provided by your employer or union, or call your employer’s benefits administrator.
If your former employer goes bankrupt or out of business, Federal COBRA rules may protect you if any other company within the same corporate organization still offers a group health plan to its employees. That plan is required to offer you COBRA continuation coverage. If you can’t get COBRA continuation coverage, you may have the right to buy a Medigap policy even if you’re no longer in your Medigap open enrollment period.
You may want to talk to your State Health Insurance Assistance Program (SHIP) for advice about whether to buy a Medicare Supplement Insurance (Medigap) policy. Since Medicare pays first after you retire, your retiree coverage is likely to be similar to coverage under Medicare Supplement Insurance (Medigap). Retiree coverage isn’t the same thing as a Medigap policy but, like a Medigap policy, it usually offers benefits that fill in some of Medicare’s gaps in coverage—like Coinsurance and deductibles. Sometimes retiree coverage includes extra benefits, like coverage for extra days in the hospital.