All right, think we can go ahead and get started here. Hello everyone. Thanks for joining today’s webinar presented by Alliant Retirement and Investment Services in partnership with Alliant Credit Union. We will have a live question and answer session at the end of today’s presentation. Please submit your questions regarding today’s topic, retiree healthcare, or about Alliant Retirement and Investment Services in the chat or the Q&A. The presentation will be recorded and a link will be provided later by email for on demand viewing. Today’s event will be hosted by our financial consultant, Shawn Floresca. Shawn is passionate about helping individuals and families work towards financial independence through thoughtful investment and retirement planning. He enjoys getting to know each client’s unique story and helping them navigate important financial decisions with greater greater clarity and confidence. Shawn believes that some of the greatest value he provides comes from listening carefully, understanding what matters most to his clients, and using his more than 20 years of experience to help guide them through an everchanging financial landscape. Outside of work, Shawn lives in Chicago with his wife, Linda, and their two sons, Mason and Lucas. He enjoys traveling with his family, whether it’s a weekend getaway to Michigan or a trip to sunny San Diego. when he’s not helping clients plan for their future. You’ll likely find him cheering from the sidelines at his son’s soccer games or spending time on the golf course. Now, I’ll hand it over to Shawn to start our presentation on retiree healthcare. Thank you so much, Brandon. And speaking of uh soccer on the sidelines, we got a a rainy one here in Chicago today and this weekend, so I don’t think that’s going to happen. But anyhow, welcome everyone to today’s presentation. Again, my name is Sean Floresa, one of the financial consultants with Alliant Retirement and Investment Services, and our goal today is to provide information and resources that can help you better understand retirey health care options and considerations. It’s also important to acknowledge that there’s no single perfect retiree healthcare strategy. Every option comes with its own advantages and limitations, and no one approach works for everyone. And at Alliant Retirement and Investment Services, we understand that each family situation is unique. And in this presentation, we’ll share key insights to help you make informed decisions about healthcare in retirement. You’ll be seeing information about how health care costs can impact your overall retirement picture, including some of the key considerations to keep in mind as those expenses continue to evolve over time. We’ll walk through the basics of Medicare, including how the different parts work together, as well as additional coverage options such as metagap and Medicare advantage. And we’ll also cover important topics like long-term care and the role it can play in your plan along with lastly resources that may help you better understand your options as you prepare for retirement. So, our team at Alliant Retirement and Investment Services is really focused on helping you understand the ins and outs of investing, saving for retirement, and so much more. So, please take a look at our website aris.allioncreditun.com
to see our list of weekly webinars, our podcast, which is called Invests Savvy, our blog, and other financial resources.
So just before we get started, just uh another disclaimer. LPL Financial and its adviserss are only offering educational services and cannot offer participants investment advice specific to their particular needs. So if you’re seeking investment advice specific to your needs, such as advisory services, these must be obtained on your own separate from this educational material. Securities and advisory services are offered through LPL financial which is a registered investment adviser and broker dealer. These are not insured by FDIC or NCUA or any other government agency and these are not bank or credit union guaranteed and may lose value. So with that let’s get started.
So we’re all well aware that the cost of medical care are rising. We see that in our insurance premiums, co-pays for doctor office visits, and prescriptions and other aspects of healthcare. A significant issue in the coming years will be that baby boomers will continue to retire in large numbers, which means that the number of older people competing for health care services is increasing as well. And they may have greater medical needs, more serious medical situations, and limited income. Our life expectancy is progressively increasing. The Social Security Administration estimates that a man reaching age 65 today can expect to live on average to age 82. And a woman who is 65 now can expect to reach on average age 84.7. Among those who are 65 today, one in four will likely live past age 90. And I’ve seen it with clients over the years. There’s a lot of people in their 90s that I’ve I’ve seen over the past decade. One in 10 will live past age 95. So, do you have spare money to cover for your medical cost as you get older? Here’s a figure that should get your attention. Fidelity estimates that a 65year-old retiring 2026 may spend an average an average of $185,500 on health care and medical expenses throughout retirement. $185,000 for a couple retiring at age 65. That could represent approximately 371,000 combined. This estimate does not include long-term care expenses. So, what will you do about your healthcare expenses when you retire?
Here are some of the topics we’re going to cover on our agenda today. So, first we’ll talk about understanding Medicare. Second, we’ll go over long-term care. And lastly, we’ll discuss some of the important resources available to you for some help.
So understanding Medicare for many individuals Medicare eligibility begins at age 65 and then it often becomes an important part of retirey health care planning. For many retirees, Medicare serves as the foundation of their health care coverage. It is a federal government program that helps older and some disabled Americans obtain and pay for medical care. It’s administered by the US Department of Health and Human Services. The program is divided into three components. Part A, which covers hospital cost, part B, which covers doctor and other health provider office visits and other medical cost. and part D offers coverage for prescription drugs. Let’s take a closer look at each part.
Part A of Medicare is called hospital insurance. It covers most of the cost of uh stay in the hospital as well as some follow-up expenses after you spend time in the hospital such as a period in a rehabilitation or nursing home. Part A pays some outpatient medical services, including some health care, home health care. It does not cover prescription drugs since those are covered under part D, which we’ll talk about here in a bit. In most cases, you do not have to pay a premium for part A. Specifically, if you have 40 or more quarters of Medicare taxed employment, you pay no premium.
Medicare Part B is what we might think of as a medical insurance. This optional coverage is intended to help pay for doctor’s bills for treatment in or out of a hospital. It also covers many other medical expenses you incur when you are not in the hospital, such as cost of durable medical equipment and tests. In 2026, the Part B deductible is $283. Again, $283 for Part B deductible. If you choose Part B, a monthly premium is automatically deducted from your Social Security check. If you are not receiving Social Security benefits, other payment arrange uh arrangements are made.
How much does the monthly premium for part B cost in 2026? The standard monthly premium is $22.90.
Your premium would be higher if your modified adjusted gross income on your 2024 federal income tax return was $19,000 or more if you filed single. or it would be 218,000 or more if you’re married and filing jointly. In these cases, premiums would range from $284 to $689 per month in 2026.
Part D coverage is for prescription drugs and it is optional. To get this coverage, you must enroll in a plan run by an insurance company or other private company that follows the rules set by Medicare. Each Medicare prescription drug plan has its own list of covered drugs. Also, each of these plans sets its own monthly premium. You can find out the cost of these various plans available to you by going to the official Medicare website, which is quite simply www.medare.gov.
Note that some of these prescription drug plans require deductibles and co-pays in addition to that monthly premium. For 2026, Medicare Part D includes an annual out-ofpocket threshold of $2,100 for covered prescription drugs, though premiums, deductibles, formularies, pharmacies, and cost sharing can still vary by that by plan.
Now, were you wondering if there’s a part C? Yes, indeed there is. Part C includes what’s known as Medicare Advantage plans. These are optional and they’re available through private insurance companies that follow the rules set by Medicare. Medicare Advantage plans are managed health care plans and provide coverage just like an HMO or preferred provider uh provider organization. You use the plan services just as you would if they were not under the Medicare umbrella. So, for example, you may have to choose doctors from the plan’s approved network of providers or use the hospitals specified by the plan as well as follow other rules regarding accessing healthcare services. Most Medicare Advantage plans offer prescription drug coverage and again you usually have to use affiliated or the sponsor’s mail order drug provider. The availability of these plans to you depends entirely on where you reside. So again, you can learn about these plans for which you are eligible and their coverage at www.medare.gov.
Medicare Advantage plan sponsors get some or all of their premium from the amount you pay each month for your Medicare part B premium. In some cases, sponsors of Medicare Advantage plans may charge an additional amount above that Part B premium for higher levels of service. So, now let’s take a look at Metagap coverage.
Medigap coverage is private health insurance that is designed to supplement traditional Medicare. It helps pay some of the health care expenses that Medicare does not, such as co-ayments, co- insurance, and deductibles. Now, if you have traditional Medicare and a Medigap policy, Medicare pays its share of approved amounts for covered healthcare costs. Then, the Medigap policy pays its share. So, it’s different from a Medicare Advantage plan because that type of plan is a way to get medical uh Medicare benefits while a metagap policy only supplements traditional Medicare. So, keep in mind that Medicare does not pay any portion of the cost for you to get a Medigap policy. In most states, metagap policies are standardized and identified by letters such as plans A, G, K, L, as in Larry, M, and N. Benefits vary by plan, and the same letter plan generally provides the same standardized benefits regardless of the insurance company offering it. Costs can vary by insurer or location and other factors. Every policy must follow federal and state laws and each standardized metagap policy must offer the same basic benefits regardless of the company that sells it. Cost is usually the only difference between metagap policies with the same letters sold by different insurance companies.
Medicaid is a health insurance program for certain low-income individuals and their families. The program is run jointly by the federal government and each state. People aged 65 or older who meet the income and asset limits for their state are eligible for Medicaid. States set their own income and asset requirements for residents of their state. Medicaid provides a broad level of healthcare coverage and often it covers doctor’s visits, hospital costs, nursing home care, and home health care. Medicaid does does cover the cost of prescription drugs. However, this does not mean all prescriptions are completely covered. Each state can choose which medications they are willing to cover and which prescriptions they will not cover. They can also set rules regarding prescription co-ayments or shared costs. However, there are limits placed on how much the state can make the patient pay for prescriptions covered by healthc care benefits. So, please make sure to check with your state’s policies with regard to Medicaid and prescription drug coverage.
Okay. Now, on to long-term care.
The federal government estimates that 70% of people reaching age 65 are likely to need some form of long-term care during their lives. So, what are the factors that are directly related to the need for long-term care? Well, first obviously is age. So, the older you are, the more likely you will need this type of care at some point. Another factor is gender. Women, like you saw in earlier slides, live it longer than men on average, 5 years. So, they’re more likely to live at home alone when they’re older. Disability considerations also affect the need for long-term care. Having an accident or chronic illness that causes a disability can lead to a need for this care. Your health status is another factor. So chronic conditions such as diabetes and high blood pressure may mean you’re likely to need long-term care as long as you age. Then there’s family history. of chronic conditions that can also play a role. And of course, poor eating and exercise habits often increase the need for long-term care. And believe it or not, another factor is your living arrangement. So if you live alone, you’re like more likely to need paid care than if you’re married.
So what does long-term care include? Usually it is not medical care but more likely assistance with basic personal needs of everyday life which are called activities of daily living or ADLs. ADLs include bathing and dressing, using the bathroom, help with getting into or out of a chair or bed and eating. Other types of assistance may also be offered. So this type of support relates to basic everyday tasks like housework, taking medication, preparing meals, shopping for food, and and so on. Long-term care can be in a setting like an assisted living residence, a home, or other residential situations.
Long-term care insurance covers long-term services, including personal and custodial care in a variety of settings, such as we just mentioned, a home, an assisted living facility, or other residential arrangements. So, what are the factors that go into the price of long-term care insurance? This cost uh the cost of this type of insurance is based on several factors including your age when you buy the policy, the maximum amount that you want to be paid for each day, the number of days or length of the payout period, and any optional benefits you select.
Add one thing here. Well, ultimately there will be a maximum amount uh amount that the policy will pay. And remember that if you are in poor health, you may not qualify for long-term care insurance or could have to pay a much higher uh premium than someone who is healthy and satis satisfactory.
Now, thinking from a broad perspective, there may be other routes to having health care coverage when you retired. For example, you might get a part-time job that offers some form of coverage for health care expenses. More employers today are seeking out retirees to fill part-time positions and offers some level of coverage in order to attract retirees who are not interested in full-time work. You might also be able to obtain or keep coverage under your spouse’s employer sponsored health plan if he or she is still working.
Now, one of the biggest concerns that many retirees have is understanding the potential cost of long-term care and how those expenses might fit into their overall retirement plan. First, let’s talk about long-term care insurance. The cost of coverage can vary considerably based on several factors, including your age when you apply, your health status, the amount of coverage selected, and any optional features included in the policy. As an example, a healthy 55-year-old purchasing a standard long-term care policy may pay approximately $1,700 to $2,700 per year. Although actual premiums will vary from person to person and insurer to insurer, it’s also important to understand the potential cost if long-term care services are needed and paid for out of pocket. Based on 2025 national median costs, long-term care expenses can vary widely by care setting, location, provider, and level of support needed. For non-medical home care, the national median cost is approximately $35 per hour, which can equate to roughly $80,80 per year for someone needing regular assistance. for individuals who require additional support but do not need skilled nursing care assisted living facilities uh have a national median cost of approximately $6,200 per month or about 74,400 annually. The highest expenses are often associated with nursing home care. And for some of you folks out there, you might have experienced this with uh older loved ones. A private room in a nursing home has a national median cost of approximately $10,000 $10,789 per month, which is nearly $129,575
per year. These figures are not intended to alarm anyone, but rather to illustrate why health care and long-term care planning are essential and important considerations in retirement. While no one can predict their future health care needs, understanding potential cost can help individuals evaluate available options and make informed decisions as part of a broader retirement strategy.
Now, the key takeaway is that long-term care expenses can be substantial and planning before a need arises may provide more flexibility and more options in the future. So, understanding the potential costs of long-term care is an important part of retirement planning because healthc care expenses can have a significant impact on long-term financial security. So, of course, long-term care is only one piece of that healthcare puzzle in retirement. And for many retirees, Medicare will serve as the foundation of their healthcare coverage. And making informed decisions about that coverage is just as important as planning for potential long-term care needs. Unfortunately, as I’ve seen, many people make avoidable mistakes when enrolling in Medicare or selecting those coverage options. And these mistakes can lead to unnecessary costs, coverage gaps, or penalties that may follow them for years. So, let’s take a look at some of the most common Medicare enrollment mistakes and what individuals should be aware of as they approach eligibility or review their current coverage.
Now, some of the most common Medicare enrollment mistakes that can potentially increase cost or limit coverage options are the first mistake is missing your initial enrollment period. For most people, this enrollment window begins 3 months before the month they age turn age 85 and this includes their birth month and continues for 3 months afterward. So missing this window may result in delayed coverage or penalties depending on your circumstances. Another common mistake is enrolling late in Medicare Part B when you don’t qualify for a special enrollment period. Some individuals delay enrollment because they are still working or covered by an employer sponsored health plan. However, if the delay isn’t handled properly, Medicare may impose a permanent late enrollment penalty that increases Part B premiums for as long as coverage remains in force. A similar issue can occur with Medicare Part D prescription drug coverage. If you postpone enrolling and do not have what Medicare considers credible coverage, meaning other prescription coverage that is expected to pay at least as much as Medicare’s standard benefit, you could face a late enrollment penalty later. It’s also important to avoid choosing coverage without comparing costs and benefits. Medicare Advantage plans, Medigap policies, and prescription drug plans can vary significantly in premiums, deductibles, provider networks, and out-ofpocket expenses. So, taking time to compare options can help individuals select coverage that aligns with their health care needs and budget. And finally, many people enroll in a Medicare plan and never review it ever again. However, healthcare needs, prescription medications, provider networks, and plan costs can change from year to year. That’s why it’s generally a good idea to review coverage annually during Medicare’s open enrollment period to determine whether any changes may be appropriate for you. And because this presentation is taking place shortly before Medicare enrollment period, this may be a good time for individuals already enrolled in Medicare to review plan notices, prescription coverage, provider networks, and projected out-ofpocket cost for the coming year. So, the key takeaway is that a little preparation and periodic review can help individuals better understand their options and avoid some of the more common enrollment pitfalls associated with Medicare coverage. So, now that we’ve reviewed some common mistakes to avoid, let’s take a look at a few good resources that can help you evaluate your Medicare options and make more informed decisions about your healthcare coverage.
Let’s take a look at some of these resources. So, as we’ve discussed throughout today’s presentation, retiree healthc care planning can involve a number of decisions from understanding Medicare and evaluating coverage options to consider uh considering potential long-term care needs. Now, the good news is that there are several trusted resources available that can help you research your options and make more informed decisions. One of the most valuable tools is the medicare.gov planfinder. This resource allows you to compare medical uh Medicare Advantage plans, prescription drug plans, premiums, provider networks, and estimated out-ofpocket cost based on your specific location and medications. Medicare.gov gov and 1800 Medicare are official resources for comparing Medicare health uh and prescription drug plan options. Another excellent resource is your state uh your state’s state health insurance assistant program, often referred to as SHIP. SHIP counselors provide unbiased information about Medicare and can help individuals understand coverage options, enrollment periods, and plan comparisons at no cost. And then you have the National Council on Aging’s benefits checkup, which is a tool that can help individuals identify programs that may assist with health care expenses and prescription drug costs and other retirement related benefits for which they may qualify. So for those interested in learning more about long-term care planning, long-term care.gov Gov offers educational information about care options, planning considerations, and the potential cost associated with different types of care. Now, while these re uh resources can be extremely helpful, every person’s situation is unique. So healthcare needs, retirement goals, family circumstances, and financial considerations can all play a role in determining which options may be appropriate for an individual’s situation. So the key takeaway is that you do not have to navigate these decisions alone. Taking advantage of credible sources and asking questions can help you better understand your options and make informed decisions as you prepare for retirement.
So, with that, we’ve covered many of the key healthcare considerations retirees may face. Everything from Medicare and supplemental coverage options to long-term care planning and available resources. So, I’d like to conclude by sharing a few ways our team here at Alliant can help if individuals uh need to evaluate these important retirement planning considerations and continue the conversation with you if you’d like to learn more. So, when it comes to retirement planning, we can assist in assessing topics such as social security planning, 401k, and IRA reviews, as well as helping with retirement income strategies. We can also assist with investment planning and conducting portfolio reviews to discuss if your investments are in line with your objectives and risk tolerances. And we can also assist in being a resource with your estate and trust planning needs. So Medicare is essentially just one piece of that puzzle of the overall retirement picture. So again, please don’t hesitate to contact me if you have any other questions and concerns regarding your individual situation because for the past 18 years I’ve been with Alliant, I focus on creating financial and retirement plans for clients to make it a little bit easier when looking at the whole retirement picture and making that a little less confusing. So with that being said, here is my information up on the screen there. Uh so please don’t hesitate to reach out to me with any specific questions to your situation or if you’d like to set up a meeting with me directly to discuss retirement in further detail. So again, thank you all so much for coming and uh with that, I’ll give the floor back to Brandon here for some Q&A. Thank you, Sean. Uh let’s go ahead and get started with our live question and answer session. If you do have any questions for Shawn about Retiree Healthcare, Allian Credit Union, or his role as a financial consultant, please submit it in the chat or Q&A tabs. We’ll go ahead and start with the first question here, Sean. Okay. And that is a pretty specific question. Um, I’m a former pre merger United flight attendant, so I have access to the United Airlines retiree medical if I retire before 2032. I’m now 65 and still covered by active employee insurance, not Medicare yet. My question is about the UA retiree medical option. If I go on to Medicare, do I need that UA coverage? Is it mostly intended for retirees younger than 65 who don’t yet have Medicare or does it offer valuable benefits in addition to Medicare coverage? Boy, Brandon, that’s a great question and I think I’m not sure if uh if you were familiar with the uh United Healthcare plan. I’ I’ve had a couple clients ask about this, but Brandon, would you agree it just depends on coverage in terms of cost? Uh, you know, what what you’re looking at with Medicare and those supplemental plans versus the United plan that that I’m I’m not sure. Yeah, you don’t strictly need the United Airlines retiree medical coverage once you do transition onto Medicare, but it can provide you with significant value depending on how you choose to supplement your Medicare coverage. Okay. Um, now the retiree medical is heavily focused on acting as more of a bridge for retirees that are younger than 65 who don’t yet qualify for Medicare. United also explicitly uh structures a after Medicare medical plan for those that are 65 and older. So once you do turn 65 and transition from active employee insurance to retirement, your primary health coverage does shift to Medicare parts A and B because traditional Medicare has gaps like deductibles, a 20% co- insurance with no out-of- pocket maximum and no routine vision or dental coverage. Retirees usually do buy private supplemental coverage. All right. So, um, let’s move on to the next question here. When do you enroll in Medicare Part A and how do you enroll? Um, so go ahead. No, I was uh just going to say like in the presentation uh the the the initial enrollment period which again lasts for a total of 7 months. This starts the 3 months before you turn age 65 and ending 3 months after. So, uh that is again called the initial enrollment period and uh that is done through the social security administration. Brandon, right? No. Anything to add to that? I mean, if you do have social security turned on already prior to turning 65, you do get automatically enrolled into Medicare Part A as well. Uh, so there is an automatic enrollment there if you do have your social security benefits turned on prior to age 65. Um, as Sean alluded to, you do have that seven-month window 3 months before your 65th birth month, the month of 3 months after uh where you can sign up for it as well. And how you would enroll is just by calling Social Security at 1 80077213.
That’s 1 8007721213
and I will put that in the chat. Great. Thank you, Brandon. Uh, next question. If I opt for traditional Medicare instead of advantage, can I still have coverage with an HMO? Um,
okay. Let me look at this again. traditional Medicare instead of advantage, can I still have coverage with an HMO? So, the the answer to that question is no. U if you choose tradition traditional Medicare, original Medicare, you generally cannot use an HMO or a PO, which is also known as Medicare Advantage. You’re generally signing up with a metagap plan to work with traditional Medicare in those situations. If you do choose to go the Medicare Advantage route with an HMO or a PO, uh you’re effectively replacing the benefits of Medicare part A and part B with the benefits of the HMO or PO going forward.
Let’s see what the next question is.
Can you please explain what happens if you have been with Medicare Advantage for five years and want to move back to original Medicare? Uh so requiring that’s going to require um either a spe a specific enrollment period or qualification as well. Uh so to move back to original Medicare, you can do that, but you generally wouldn’t want to do that without including a metagap policy or a supplement to cover the 20% of co- insurance with no out-ofpocket maximum. Um whereas with the Medicare Advantage plan, you do have a m maximum out of pocket with that plan. So, if you do move from a a Medicare Advantage plan, an HMO or a PO back to original Medicare, you generally would want to probably qualify for a metagap policy to work with original Medicare before giving up your Medicare Advantage plan. So, you’ll want to make sure that you do indeed qualify for it from a health standpoint before you move forward with replacing your Medicare Advantage plan. Uh now when you do that and you enroll into a part D prescription drug plan that will automatically disenroll you out of a Medicare advantage plan that you were previously on. Um, so kind of the way I would facilitate that if I were in your shoes and I was serious about doing that is I would get a Medicare uh or a Medicare uh supplement or a metagap policy, one and the same thing and I would apply for that and if I am approved on that and I’m happy with moving back to original Medicare with that metagap policy, I would then apply for a part D prescription drug plan and that would disenroll me out of the Medicare Advantage plan at that point, but I would want to make sure that I at least am qualified for the metagap plan before I cancel anything um that I I currently have in place.
Let’s see here.
We’re getting quite a few questions in here, so we’ll do our best to try to cover as many of these as we can here before the end of the hour.
My spouse and I are retired but below Medicare age and have three kids. We have a small consulting company. Should we shop for insurance through the individual market or try something like a PEO, a professional employment organization to get something closer to group rates using our small business? Um, do you want to take that one, Sean? That’s a that’s a good one. Uh, Brandon, what’s Hold on a second here. So, repeat that, Brandon. Uh, Ken, please. So, they have a small consulting company. They have a couple of kids. Uh, it’s a family here. They’re debating whether they should shop through the individual state marketplace for premedicare plans or if they should try something like a professional employment organization to get something closer to a group rate versus an individual rate. I would just absolutely compare cost. That’s a great question. I have had one other person ask about that situation and again I think it’s depending on cost now through the marketplace Brandon are you familiar with um because I was more um familiar with individuals not uh you know companies or businesses through that that site do you know um what’s going on with that? Yeah, that’s a pretty unique question. And I mean, I I I would pursue both options and just have all of your options in front of you before you make a decision so you can see what the benefits actually are and what the actual costs are and then make a decision from there. Yeah, that’s that’s a good question because comp I did not know that businesses can go on to the marketplace. I thought there was more individuals uh you know to to qualify for those type of plans. That’s good to know.
question here is when does your Medicare coverage start? Uh, I could address that pretty quickly. It would be the month that you turn 65 as long as you have your part A and part B active. So, when you do get your Medicare card, there’s an actual effective date for part A and part B on that card
is a good question. Uh, can HSAs be used to pay for long-term care and Medicare? I don’t know that you know that one off the top of your head, Sean. I can address that if you’d like me to. There’s a lot of good questions that Yeah. know. Yeah. So, with an HSA, you are able to use it for specific things towards uh Medicare. There are specific things that you’re not able to use it towards. A uh paying for your metagap premium would be one of the restrictive items uh with an HSA. You’re not allowed to do that. Uh, but you could use it for dental expenses, vision expenses, um, other out-of- pockets that are out there. Um, so there are some some specific rules with that. Um, I would suggest reaching out to one of our consultants. Um, if you do want to get kind of a detailed list of what what applies and what doesn’t apply there.
This is actually a really great comment and and something that probably should have been mentioned in the uh presentation. Uh people rarely mention turning off your HSA deposits or contributions 6 months before retiring because you can potentially pay fines. So that is something worth considering when you are approaching retirement if you are contributing to an HSA.
And Brandon, this next question I actually had uh experience with with a client. The um this one, do you need any Medicare supplements if you have Texas UT system, UTRA, Medicare, which includes A, B, D, and possible long-term care uh and short-term health insurance. And the the good thing about this, and I don’t know if you knew this, Brandon, is that uh the UT care plan functions as more of like I guess an open access Medicare Advantage PO and bundles medical, hospital, and prescription coverage together. And that’s one thing I did not know about until recently. So that’s
the answer to that question would be no because they do bundle the benefits together, provide a max out of pocket, right? Yep. That’s that’s exactly it. They’re they’re one of the the plans that that bundle everything together. So, yep. No uh any no Medicare supplements if you are in specifically the the Texas UT uh care plan.
The next question here is uh somebody is asking they’re self-employed. They’ll be 65 in a few months. They do not receive nor do they plan to receive their social security until age 70. So, they’re delaying. Uh, they take no medications. I will be enrolled in Medicare Part A during the initial enrollment period. When do I enroll in Part A and Part ND? Um, I can answer this quickly. You can enroll into Part A 3 months prior to your 65th birth month. So, if your birth month is, let’s call it June, you would be able to apply in, let’s see, June, you would be able to apply in March. in that situation. So, March 1st would be the first date you could apply. U as far as part D goes, I would recommend uh also applying for part D once you do have part A active. Uh the reason you’re going to want part D in the mix here is because you will well if you are let’s see I’m employed do not receive social security. So, I assume um with moving on to part A, you’re going to also turn on part B. So, you will need part B to go along with A and B um and then a supplement and then part D, which is the drug plan there. Even though you’re not taking prescription drugs, I would recommend just finding the cheapest uh premium plan that’s out there and enrolling into that. There might be one in your area that’s offered for zero a month, but at least you have the qualified coverage at that point and you won’t be subject to penalties down the road. Uh, should you need prescription drugs at some point?
I am 65. Okay, next question. I’m 65, employed full-time with an employed sponsored health insurance. I also contribute to an HSA. My employer is more than 20 employees. I understand that it’s best not to enroll into Medicare Part A and B at this time. Is this correct? Yeah, I I can take this, Brandon. Yep. because you are in your uh employer’s health care plan uh your understanding is correct because you can delay both A and B without penalty um but uh because your employer has you know 20 or more workers your job based I guess health plan acts as that primary coverage so uh do not do not enroll um but once you do enroll and and Brandon correct me if I’m wrong once you enroll in Medicare then your HSA pays you cannot put any more money in that. Is that correct? That’s correct. Okay.
And the with that question, you you have what is known as credible coverage. Um even though you’re 65, you’re still with the employer. There’s more than 20 employees there. So, you’re not subject to any penalties down the road. enrolling into Medicare once you do lose that credible coverage from your employer either, you know, at at no fault of your own is generally kind of the consensus there. So, when you retire, they they take it from you. It’s at no fault of your own. And then you would then you would qualify for a special enrollment period through Medicare uh where you would be able to sign up for a Medicare Advantage plan, a metagap plan, and a part D plan. You know, however you want to have that uh shaped for the future.
All right. Here. Still have a quite a few more questions. I’m trying to We’re going to try to work through as many of these as we can. If I’m still working, can I sign up for for Medicare outside of part A once retired at any time or only during the enrollment period? Well, so so I’m I’m assuming Brandon, anything outside of part A, so Medicare part B, uh if if you are uh you have to do it during that uh special enrollment period, which is eight months starting the year after you start the month after you stop working. Is that right, Brandon? So you retire at the end of that month, you would technically lose your credible healthc care coverage through your employer. Uh you then have 61 days, I believe, to enroll into a Part D drug plan and 3 months to enroll into a metagap plan uh or a Medicare advantage plan. Now, keep in mind if you choose the Medicare Advantage route, generally you have your Part D plan that comes with that. But you do want to make sure that your Medicare Advantage plan covers prescription drugs as well when you’re enrolling into it because they do offer Medicare Advantage plans that don’t have prescription drugs.
Let’s see here. Uh
John talked about a part-time job after retirement. What’s the minimum employer healthc care coverage needed to still qualify for a credible coverage exemption for part B? You can. So that that’s just 20 employees on their healthare plan. If you qualify for their plan, you would be able to enroll into it as long as they have 20 or more employees, you should have those can be either part-time or full-time employees. Correct, Brandon? Yes. Okay. So, it just depends on the company, right? If they offer healthcare coverage to part-time employees. A lot of them don’t, right? But some may.
Next question. My husband is still working, has not filed anything. He will be 68 in December. Is this okay? he plans on retirement in 2027. Uh I think we’ve kind of addressed that. Should be okay as long as he’s got 20 or more employees on his healthcare plan through his employer. Um you know, once he retires, he’ll qualify for that special enrollment period.
See, as a US citizen and a non- tax filer living in Mexico, will I be qualified for Medicare? Um, so as long as you have 10 years paid into uh social security taxes, you should qualify for part A. Uh, part B there is a premium for. So you would have to pay for that out of pocket, but you should be able to uh apply for for Medicare even though you are living in Mexico at this point. Yeah, you just need to be aware uh when you are signing up for uh you probably won’t want to go the Medicare Advantage route because those are based on regions and with you being outside the US, you’re not going to have really any coverage with a Medicare Advantage plan there. Um you may want to go with the Medicare supplement there. Um there are restrictions on out of the country care, so you do want to pay attention to that. But that’s where my focus would be if I’m outside the country and I’m looking at utilizing Medicare as health coverage.
So, uh, next question. I’m nowhere near retiring. I’m about 26 years out, but can you please speak to this administration’s proposed changes to retirey care and what we can expect going forward? Um, good but tough question. That is a tough question. Um I I’ll preface it with this and I’ll let you kind of take it Sean. Uh you know the senior population in the country is the largest voting block in the country today. Uh personally I think if a politician was going to try to gut or change Medicare, it’s it’s kind of like shooting themselves in the foot, so to speak. Absolutely. I’ll let you take it from there, Sean. No, just like you were saying, it’s it’s so far out, but but again, when you need to make or want to make a change to the system, it is going to feel the shake across the board. And so, you know, I I’m just hoping at least even though it’s 26 years out, we see progress even in the next few years. And I think, you know, if we can start by, you know, for example, lowering prescription drug prices, right? um and and not keep these premiums just rising astronomically as as the years go on. But again, that’s a question I get all the, you know, pretty often and it’s it’s hard uh to answer just because of uh the way, you know, um the powers that be are you are are addressing things and just, you know, it’s always a what do you call this? A uh uh what do you call tugof-war about what’s what’s going on in in in that, you know, sector of of uh healthcare. So, that’s going to be interesting. I I wish we had a a better answer, but we just have to kind of wait and see and see how how we progress, you know, in the years to come. And 26 years away is is definitely a long way out. So, let’s see what happens. I’ve gotten this uh a few times here, so I’ll I’ll just kind of address it here. Um what are options for health care if you retire before 65? Uh, generally speaking, I the first place that I would go to is your state specific uh, insurance exchange. Your state should have a website with all the insurance options that are on there that you’re able to shop through. Uh, so you could search that up on Google. Just type in your state insurance exchange and it should be one of the top options that pop up there for you. Um, another question I got here, Sean. Um, I’m a snowbird. Seven months in New York, five months in either North Carolina or Tennessee. Some of this seems to be state specific. What if I sign up for a plan in New York but have an accident or get sick in North Carolina? Um, that’s a great question. Never dealt with that one before, Brandon. Yeah, happy to dive into that. Um, so there’s kind of two different trains of thought here. It kind of depends on what you have in place. If it is a Medicare Advantage plan, I would seek to make sure that my network provides coverage in all three of those states that that I know I’m going to be spending time in and just get a firm understanding of where those networks are. Um, in addition to that, you can uh, you know, find, uh, on the Medicare Advantage side, you can look up like Humanana where their hospital networks are and and determine is there one near where I’m staying in Tennessee that I could utilize in the event that I do get sick there when I’m snowbirding. Uh if you are going the metag gap route, all that really matters there is that the doctor in the area takes original Medicare and they’re willing to see you. Uh because Medicare remains your primary on the metagap side. On the Medicare Advantage side, whatever company you sign up for becomes your primary there.
So we got time for about one or two more questions here and I apologize if we were not able to address your specific question. Uh you are more than welcome to send your question to Sean. Uh his email address is up on the screen here if we were not able to get to it today and we’re happy to address that. Next one here is I will be 65 next February. I’m retired already. If I get employed again in a full-time with health insurance plan, should I delay my Medicare enrollment initial window? It’s a good question. Um I think timing plays a big big part there. Um, if you get the the the job prior to your initial enrollment period coming about, that’s definitely an option. If your initial enrollment period comes about prior to that occurring, I would probably just move forward with going on Medicare because you you you can only plan for what you know today. Yeah.
So, here’s a question uh that we’ll end on here, and it’s it’s kind of more related to the Social Security spousal benefits. Uh but my husband passed away 17 years ago. My condolences. He would have been 62 like myself. Can I receive his Social Security now or do I have to wait until he would have been 65?
Brandon. So for that one, um you can receive the so the survivor benefits now uh at 62 because surviving spouses, correct me if I’m wrong, Brandon, that can start collecting as early as age 60. Correct. So nope, you do not have to wait.
All right, let me see if there’s one that we can pop in here real quickly to end it on.
Um, okay.
If you deferred it for an entire year, are the penalties to start once I retire in 2027? So, I assume this is somebody who was eligible for Medicare um may not have had credible coverage um while they were eligible for Medicare and then they’re looking to start during the general enrollment period here at the beginning of 2027, apply for part A and apply for part B. Unfortunately, in that situation, there will be a small penalty uh incurred for the late enrollment. uh it’s based on how how long that delay was from when you were eligible versus when you actually signed up. Um but if you did have credible coverage through an employer 20 or more employees during that period of time, you would not be subject to that penalty. So
this is going to conclude our Q&A session. Uh if you do again have any additional questions or would like to schedule some time with Shawn, please do reach out to him. We do thank everybody for attending today and have yourselves a wonderful day. Appreciate it. Thank you all.