Jeffrey Wade
Verizon offers its retirees comprehensive and adaptable healthcare benefits, including medical and life insurance coverage. However, it is important for retirees to understand how their Verizon medical insurance interacts with Medicare. Medicare is a federal government-backed health insurance program that becomes available to individuals at age 65. When a retiree becomes eligible for Medicare, they and their Medicare-eligible dependents must enroll in Medicare Parts A and B to receive full benefits from their retiree coverage. Medicare generally becomes the primary coverage, and the retiree's medical and MH/SA benefits payable under the employer-sponsored plan will be reduced by the amount Medicare Parts A and B would have paid. In some cases, Verizon reimburses retirees for a portion of their Medicare Part B premium costs.
| Characteristics | Values |
|---|---|
| Medicare eligibility | Contact the United States Social Security Administration at (800) 772-1213, your local Social Security Office, or ssa.gov |
| Medicare enrolment | Enrol in Medicare Parts A and B |
| Medicare and retiree coverage | Medicare pays first for healthcare bills, then the retiree coverage pays the remaining amount |
| Medicare Part B | Monthly premiums are deducted from your Social Security check. Verizon reimburses you for a portion of these premium costs |
| Medicare Advantage | May offer coverage for dental, hearing, and vision insurance |
| Medicare Advantage and Original Medicare | Medicare Advantage requires a referral from a primary healthcare provider to meet a specialist, whereas Original Medicare permits direct consultations with specialists |
| Medicare Advantage and out-of-pocket costs | Medicare Advantage plans had a higher out-of-pocket maximum in 2020 compared to most private employer plans |
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What You'll Learn
Medicare enrolment and eligibility
Medicare Eligibility:
Medicare eligibility typically begins when an individual turns 65. However, there are instances where one may be eligible for Medicare before the age of 65. This includes individuals with a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). In such cases, early Medicare enrolment is possible. For those under 65 without these conditions, it is essential to wait until the Initial Enrollment Period, which starts three months before turning 65 and ends three months after the birthday, a total of seven months.
Automatic Enrolment:
Individuals already receiving Social Security or Railroad Retirement Board (RRB) benefits at least four months before becoming eligible for Medicare (at age 65) are automatically enrolled in premium-free Medicare Part A and Part B. Those receiving Social Security disability benefits will automatically receive Medicare Parts A and B after 24 months of receiving disability benefits. For those with Lou Gehrig's Disease (ALS), Medicare Parts A and B are immediate upon enrolling in Social Security disability benefits.
Enrolment Process:
For those who are not automatically enrolled, there are several ways to sign up for Medicare. Individuals can enrol online through the myGov portal, which allows tracking of the application's progress. Alternatively, one can enrol by contacting the Social Security Administration via phone or by visiting their local Social Security Office. It is recommended to contact the Social Security Administration before retiring from Verizon to determine eligibility and enrol in Medicare.
Medicare Parts:
Medicare is divided into several parts, each covering different aspects of healthcare. Medicare Part A covers hospitalization, home or skilled nursing, and hospice care. Most individuals receive Part A for free, but some must pay a premium. To be eligible for premium-free Part A, an individual must meet specific requirements based on their own or their spouse's, parent's, or child's earnings. Medicare Part B, which is medical insurance, often requires a premium. To enrol in Part B, individuals must meet additional requirements, including being a U.S. citizen or a permanent resident for at least five continuous years.
Medicare Advantage Plans:
Medicare Advantage Plans, also known as Medicare Part C, are private insurance options that cover hospital and medical costs. These plans sometimes offer additional benefits, such as dental, hearing, and vision insurance. Medicare Advantage Plans may also include prescription drug coverage (Part D), although this can vary between plans.
Verizon Reimbursements:
For Verizon retirees, it is important to note that Verizon may reimburse a portion of the Medicare Part B premium costs. The Verizon Benefits Center will automatically enrol eligible retirees for reimbursement once they become Medicare-eligible, with payments made quarterly.
Understanding Medicare enrolment and eligibility is crucial for Verizon retirees to ensure they receive the maximum benefits and effectively plan for their retirement healthcare needs.
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Medicare Advantage plans
Most Medicare Advantage plans are either HMOs or PPOs. HMOs generally cover only care provided by in-network doctors, hospitals, and other health providers. PPOs offer access to out-of-network providers but at a higher cost than in-network providers. PPOs can be local or regional, with regional plans serving a single state or group of states.
There are also Special Needs Plans, which are Medicare Advantage plans designed for people with high healthcare needs, and Employer Group Plans, which are Medicare Advantage plans for employers' retirees.
For Verizon retirees, it is important to understand how Medicare eligibility affects your plan options. When you first become eligible for Medicare, you and your Medicare-eligible dependents must enroll in Medicare Parts A and B. This will affect the medical benefits provided by your employer, as Medicare generally becomes your primary coverage. Verizon may reimburse you for a portion of the monthly premium costs for Medicare Part B coverage, and you can review your coverage and make changes through BenefitsConnection.
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Out-of-pocket expenses
Firstly, it's important to understand the difference between private employer plans and Medicare Advantage plans in terms of out-of-pocket maximums. While most private employer plans offer a cap on the maximum out-of-pocket costs for covered services, Medicare Advantage plans may result in higher out-of-pocket expenses, especially during health adversities. For example, in 2020, the average out-of-pocket maximum for Medicare Advantage plans was $5,059 for in-network services and $8,818 for both in-network and out-of-network services combined, according to the Kaiser Family Foundation. Therefore, while Medicare Advantage plans may offer low premiums, the potential out-of-pocket expenses could be significant.
Secondly, as a retired Verizon employee, your Medicare eligibility will impact your plan options. If you or your eligible dependents do not enroll in Medicare Parts A and B as a Verizon employee, your provider may bill you for amounts not covered by Medicare or your Verizon medical plan, increasing your out-of-pocket expenses. According to the Employee Benefit Research Institute (EBRI), Medicare covers approximately 60% of a person's medical expenses, so not enrolling in Medicare could result in higher out-of-pocket costs.
Thirdly, Verizon offers various tools and resources to help manage out-of-pocket expenses. This includes flexible spending accounts (FSAs) and health savings accounts (HSAs) that can be used to pay for current and future qualified medical, dental, and vision expenses, even in retirement. Additionally, Verizon provides a health care spending account (HCSA) where you can use pre-tax contributions to cover eligible medical expenses, including your deductible, copays, and coinsurance.
Lastly, it's worth noting that if you are enrolled in Medicare Part B coverage, monthly premiums will be deducted from your Social Security check. In some cases, Verizon may reimburse you for a portion of these premium costs. However, you will need to enrol in direct deposit to receive these reimbursements electronically.
In conclusion, when considering Verizon retirement medical insurance and Medicare, it's important to carefully assess the potential out-of-pocket expenses associated with each option. While Medicare Advantage plans may offer low premiums, they may also result in higher out-of-pocket costs during health adversities. Therefore, it is crucial to understand your plan options, utilise the tools and resources provided by Verizon to manage out-of-pocket expenses, and make informed decisions based on your unique circumstances and healthcare needs.
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Medicare Part B reimbursement
Medicare Part B covers around 60% of a person's medical expenses, with beneficiaries paying a $226 deductible and 20% of the Medicare-approved amount for any medical services and supplies. This can be costly, so many beneficiaries seek reimbursements or other ways to reduce these expenses.
If you are a retired Verizon employee, you can be automatically enrolled for reimbursement of a portion of your premium costs. Payments are made quarterly in January, April, July, and October, either through direct deposit or by paper check.
For retirees in New York City, reimbursement is available for Medicare Part B premiums paid, excluding any penalties. You must be receiving a City pension check and be enrolled as the contract holder for City health benefits to receive reimbursement. For most retirees, the refund is issued automatically by the Health Benefits Program. If you are receiving your pension through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement will be deposited directly into your bank account. The reimbursement amount is based on the standard Medicare Part B premiums.
In Hawaii, the Employer-Union Health Benefits Trust Fund (EUTF) reimburses retirees for Medicare Part B premiums, excluding penalties and IRMAA. To be eligible, retirees must be enrolled in Medicare Part B and submit a Direct Deposit Agreement Form and a copy of their Medicare card.
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Social Security benefits
Medicare is a health insurance program for people aged 65 and older, as well as some disabled people under 65 and people with permanent kidney failure or end-stage renal disease. It is a separate program run by the Centers for Medicare and Medicaid Services, and it helps pay for inpatient hospital care, nursing care, doctors' fees, prescription drugs, and other medical services and supplies.
There are four types of Medicare coverage, known as "parts". Part A is hospital insurance, which most people do not have to pay for. Part B is medical insurance, which covers doctors' services, outpatient care, and other medical services such as physical therapy and some home healthcare. Most people pay a monthly premium for Part B, and the government typically pays about 75% of the Part B premium, while the beneficiary pays the remaining 25%. Higher-income beneficiaries pay a larger percentage of the total cost of Part B, which is adjusted based on their income.
For those with Social Security Disability Insurance (SSDI) benefits, there is a 24-month waiting period before they become eligible for Medicare coverage. During this time, they may be eligible for health insurance through a former employer. After this qualifying period, they can purchase Premium Hospital Insurance (Part A) and Premium Supplemental Medical Insurance (Part B) at the same monthly cost as other uninsured eligible retired beneficiaries.
If you have limited income and resources, you may be able to get Extra Help with the costs associated with Medicare, including monthly premiums, annual deductibles, and prescription copayments. This assistance can be applied for by calling 1-800-772-1213 (TTY: 1-800-325-0778).
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Frequently asked questions
If you have both, Medicare pays first for your health care bills. Medicare will submit any amount it doesn't cover to your retiree plan.
Understanding and claiming Social Security can be problematic for many Verizon retirees. It is important to know the fundamentals of Social Security to receive the maximum benefit. A study found that retirees who delay claiming Social Security benefits until the age of 70 can significantly increase their Medicare premium savings.
Medicare Advantage plans offer coverage for areas not normally offered within regular Medicare plans, including dental, hearing, and vision insurance. However, Medicare Advantage plans have higher out-of-pocket maximums, and require an additional layer of processes to meet a specialist.
If you don't buy a Medigap policy within 6 months, you may not be able to buy a policy later, or you may have to pay more.
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