COLUMBUS – Many baby boomers may be considering the idea of early retirement in 2012. For some, a lifetime of working could mean a good pension and benefits, but more companies are changing their retirement benefits leaving boomers to find alternative health insurance.
Lieutenant Governor and Department of Insurance Director Mary Taylor encourages boomers to utilize resources designed to help them understand coverage options before Medicare eligibility begins at age 65.
“Before reaching retirement, talk to your employer as well as your insurance agent and get a sense of what options are available,” Taylor said. “Planning ahead will help you find the best coverage option making the transition into retirement easier and less stressful.”
If an employer is not offering to extend health insurance coverage beyond the boomer’s retirement date, Taylor said the following options should be considered:
Spouse's Policy: If your spouse is still employed and has access to benefits, see if you can be added to the policy. This is likely your most affordable option.
COBRA: The Consolidated Omnibus Budget Reconciliation Act (COBRA) lets former employees and their dependents continue coverage up to 18 months. While your employer cannot refuse coverage through COBRA, it is unlikely that they will continue to subsidize the premium. They may also charge an administrative fee.
Military: If you are a retired military veteran, you may be eligible to join the Defense Department's Tricare plan. You can learn who is eligible for TriCare coverage at www.tricare.mil.
Individual Coverage: Because these plans can be complicated, utilize your insurance agent to find the right policy. Make sure to ask if vision, hearing and dental coverage are included or if it is possible to add them.
Ohio High Risk Pool and Open Enrollment: A high risk pool was created in Ohio to help adults with pre-existing conditions find individual coverage. To be eligible for this subsidized coverage certain qualifications must be met. Visit www.ohiohighriskpool.com for more information. Participating open enrollment insurers are required to offer coverage at a limited cost to people who apply on a first-come, first-serve basis. Also, certain requirements must be met. Information is available at www.insurance.ohio.gov.
High Deductible Health Plans (HDHP): These plans only cover catastrophic health care costs. This means you will be responsible for paying more of the upfront cost before the policy pays for eligible medical expenses. HDHPs have a lower premium to compensate for the higher out-of-pocket costs incurred with these high deductibles. Often HDHPs work with a Health Savings Account (HSA) that allows you to set aside funds for future qualified medical expenses.
Taylor said it is critical to understand the terms and coverage of the different policy options and to keep in mind that the lowest premium option may not provide the coverage you need for your health status. It is also important to have the following questions answered when comparing coverage:
- What are the deductibles or coinsurance payments?
- What are the limits on coverage?
- Can I see my current doctor or seek treatment in the same hospitals?
- Is there an annual limit to what the insurance company will pay for any particular coverage?
- Is there a cap on the out-of-pocket amounts I have to pay?
- How often will my policy be reviewed or how often can I expect a premium change?
- Are prescription drugs covered?
Boomers with health insurance questions can call the Department’s consumer hotline at 1-800-686-1526. Ohioans seeking information about Medicare should call the Department’s Ohio Senior Health Insurance Information Program (OSHIIP) at 1-800-686-1578. Information is also available at www.insurance.ohio.gov.