What you need to know about Medicare before you retire

By Regence
July 06, 2023

Summer is a popular time for people to retire, and retirement usually means leaving your employer’s insurance plan and enrolling in Medicare. But not understanding some of the complicated nuances of Medicare can end up costing you thousands of dollars.

Here are some things you should know about Medicare before it’s time to enroll:

  • You might, or might not, have to get it at age 65. Some people must enroll in Medicare at age 65 or face a lifelong penalty. This includes people on COBRA or retiree benefits (such as military retirement), and those who work for an employer with fewer than 20 employees. But if your employer has more than 20 employees and offers insurance coverage, you can stay on your employer’s insurance until you’re ready to retire. If you have a spouse or child on your existing plan, or if you want to continue investing in a health savings account, then staying on your employer’s plan might be a good idea. If you want to get your full Social Security benefit, you might want to delay retirement until you reach your full retirement age as defined by SSA.
  • You must sign up at the right time or risk delays in coverage and penalties. There’s an initial enrollment period for Medicare right around your 65th birthday. If you delay your retirement past 65, there’s a special enrollment period right around the time of your retirement. If you miss the enrollment periods, you could face penalties for the rest of your life.
  • Medicare isn’t free. You can get premium-free Medicare Part A — hospital insurance — if you or your spouse paid into Social Security for at least 10 years. But Part A has deductibles and the benefit periods reset multiple times per year. Part B — which covers services provided by health care providers, as well as durable medical equipment — requires monthly premiums and deductibles. Part D also requires premiums, deductibles and copays.
  • Original Medicare doesn’t cover everything. There are many things Medicare Part A, B and D don’t cover, such as dental, vision and hearing services. If you want coverage for those services, you’ll need to enroll in a Medicare Supplement (Medigap) plan or a Medicare Advantage plan administered by a private insurance company. Medigap plans cover gaps in Original Medicare coverage like co-pays, coinsurance and deductibles. Medicare Advantage plans cover all the gaps and also offer extended benefits, like wellness services.
  • It’s a good idea to get some help navigating this complicated stuff. There’s lots of information available on medicare.gov that can help. But it’s a good idea to find someone who can help you make decisions based on your individual situation.

We’re here to help you

There’s a recently updated Medicare guide on regence.com that includes lots of helpful information about Medicare, how it works, when to enroll, what plans are available and much more. You can also get help by calling our Regence Medicare plan advisors at 1-844-734-3623 (TTY: 711).