Council on Aging Answers 2016 - 91

COUNCIL ON AGING - ORANGE COUNTY

Retiree Benefits vs.
Medicare: Know the Risks
n Linda Walton RN, MS, Council on Aging - Orange
County

Council On Aging-Orange County | 714-479-0107 | www.coaoc.org	 Answers Guide 2016

91

INSURANCE

Retiree health plans can vary widely so it is important to know what benefits your plan provides,
and how or if it coordinates with Medicare.
As a general rule, retiree health plans are equal to
or better than Medicare. They offer a broader prescription drug benefit, and some include vision and
dental plans that are NOT included with Medicare.
Retiree health plans coordinate with Medicare; they
are not considered Medigap plans.
Medicare is your primary coverage; your retiree
benefits pay after Medicare.
According to the California Health Advocates,
retiree health plans may provide traditional fee-forservice coverage or will cover you through a Medicare Advantage plan (HMO / PPO). These plans require enrollment in Medicare parts A and B. While
called a Medicare Advantage plan, the retiree health
plan will have negotiated benefits that may be very
different from an Advantage plan offered through
Medicare. Some retiree health plans automatically
supplement Medicare benefits; others may apply deductibles or not cover expenses traditionally covered
by Medicare.
Questions to consider before making a decision
regarding your retiree health plan:
n Does it coordinate with Medicare?

n How do the costs of the retiree plan compare
with Medicare costs?
n Does it have a "creditable coverage" prescription drug program?
n Does the retiree plan include dental, vision,
and hearing benefits?
n How does the retiree prescription drug plan
compare to a Medicare Part D drug plan?
n Is there coverage for my spouse?
To understand your retirement insurance coverage, contact your company's Human Resources Benefits Coordinator. Compare and evaluate the risks.
Learn whom to contact regarding benefit changes or
if you experience payment problems. If you are considering changing your existing retiree plan to Medicare, understand the details. Many retiree plans will
not let you re-enroll if you change to Medicare.
To learn more, contact the Council on AgingOrange County Health Insurance Counseling &
Advocacy Program (HICAP) at (714) 560-0424. Appointments to meet with a HICAP counselor at no
cost are available in most of the senior / community
centers in Orange County. Call your local center and
request an appointment with the HICAP counselor.
HICAP is a no-cost service to help you understand
and maximize your Medicare benefits. Funded in
part by the California Department of Aging, HICAP
is the most dependable source of unbiased, accurate
and up-to-date Medicare-related information.



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Table of Contents for the Digital Edition of Council on Aging Answers 2016

Contents
Council on Aging Answers 2016 - Intro
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