Woman and older woman walking down hall at hospital

Finding the Retirement Health Insurance That’s Right for You

Make Your Health a Priority

If you are one of many senior citizens who has retired, you may be in need of quality, affordable retirement health insurance. Regardless of whether you are under 65 or over, help is available to guide you in finding the best health insurance coverage for your specific needs.

Between the ages of 62 (just eligible for Social Security benefits) and 65 (eligible for Medicare benefits), you can look to the Marketplace to guide your insurance choice. After age 65, you have multiple choices of Medicare policies.

The Marketplace

Ordinarily, new insurance choices must be made during the Open Enrollment Period each year (November 1 through December 15) for the following year.

Exceptions are made for people with certain life events, such as retirement and the subsequent loss of employer-based health insurance. In that scenario, a Special Enrollment Period is available.

By filling out an application with the Insurance Marketplace, you can discover whether you qualify for a private insurance plan with reduced out-of-pocket costs and premium tax cuts. These things will be determined according to the number of people in your household and your income level.

You can also find out if you are eligible for free or reduced-price Medicaid benefits, which will be determined by your particular state.

Medicare Plans Available for Retirees

All American retirees at the age of 65 qualify for Medicare Part A. This coverage helps with hospital charges and also provides some coverage for skilled nursing care and rehabilitation facilities, as well as some nursing homes/assisted living facilities.

Part B Medicare covers charges by medical providers, such as doctor visit charges and services such as lab, x-ray and pathology. Each person on Medicare Part B pays a monthly premium, usually from their Social Security account, for this coverage.

Alternatively, one can opt for Medicare Part C, which includes Medicare Advantage plans such as those provided by AARP, Bluesheild, Humana, Unitedhealth Care and Wellpoint.

Medicare Advantage (MA) includes Part A and Part B coverage and more. Many plans, such as AARP Medicare Advantage, offer hearing and vision benefits and fitness programs to promote better health.

Some advantage plans, called Medicare Advantage Prescription Drug Plans (MAPD), bundle Part A and B Medicare with Part D (prescription drug coverage) for an all-in-one kind of coverage.

A major provider of Medicare Advantage Plans is Blue Cross Blue Shield. Blue Cross covers hospital charges, while Blue Shield helps with charges from healthcare providers. Some services in this category include:

  • Outpatient diagnostic tests
  • Ambulance fees
  • Durable medical equipment costs
  • Outpatient care
  • Preventative procedures such as mammograms and Pap smears

Humana Medicare Advantage Plans feature combined coverage as described above in the form of HMO (Health Maintenance Organization), PPO (Preferred Provider Organization) and PFFS (Private Fee-for-Service) policies. They also offer separate prescription drug plans and Medicare Supplement Plans (to cover charges not paid by Medicare Part B).

UnitedHealthcare and Wellpoint also offer Medicare Advantage Plans, Prescription Drug Plans, and Medicare Supplement Policies. These plans, in order of popularity, are:

  • Part F – Most expensive plan with comprehensive coverage
  • Part G – Does not cover annual deductibles
  • Part N – Less expensive, but has more out-of-pocket expenses
  • Plan C – Least expensive. Does not cover excess charges some providers charge

A simple phone call to The Center for Medicare and Medicaid Services can start you on your way to discovering which policy is best suited for your specific needs.