He is still working so still has insurance, but wants to understand for when he’s primarily Medicare.
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If his insurance is “creditable coverage” (primary to Medicare), he should be fine until he resigns, laid off, or retires, or the company changes its plan so it is no longer primary to Medicare. This is my husband’s situation now. He is covered under my plan, but if something happens, he will quickly apply for Medicare until the COBRA grace period runs out.
Medicare has all of this spelled out on their site pretty clearly.
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Also, in most states one can work with a broker who knows about Medicare and many options. We have a number of friends who did this and were very satisfied with the information and their eventual coverage. They started these discussions well before they retired,
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I have been covered through the ACA Marketplace since retiring last summer. I will be on it for another 16 months until I can switch to Medicare. I actually will pay more for Medicare since 1) we set these years up to have very little taxable income so I get a good subsidy, 2) I picked a bronze plan to keep the premiums down and 3) I plan to have traditional Medicare with a supplement and part D. My take on the ACA Marketplace bronze policies – they are fine for preventative care because much of it must be covered due to federal regulations and they are okay for a very serious illness that would get you to the out-of-pocket max quickly on any policy. They aren’t great if you have one or two $5000 medical experiences a year, except that the insurance company will have negotiated lower costs than if you had no coverage. But maybe that’s true of most insurance these days. Anyway, it was easy to sign up for, I chose a policy that my primary care doctor takes, and I have an HSA from work that will cover the $9000 deductable if needed. Trying to stay well until Medicare!
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Sounds like you did some good research and came up with a reasonable plan.
I think this will be true for us also - we have subsidized marketplace insurance because we have almost no income at this time. We will have more income when social security and required 401K withdrawals start happening when we hit retirement age.
And a younger person’s life could be transformed by the opportunity to take over that job.
My entire life was made possible by ACA. As a result, I could leave my day job and put all my efforts into my educational counseling business. This has gone better than my wildest dreams. I got busy enough that my husband could leave his job to manage my practice. I’m making way more money than I did as a lawyer, while working part time, from any location I choose, doing work that I love and that my clients need and cannot find elsewhere. I created two jobs, I’m paying lots more in taxes, we’re super happy – everybody wins, all because people with pre-existing conditions won the right to buy health insurance.
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That’s wonderful! And it would be even better if we did it like Canada and didn’t have to pay for the ACA.
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Here’s a tangential question : A relative has federal retiree insurance and one if his adult sons is covered as he is deemed disabled. If the parent passes away, does the disabled son lose his healthcare benefit?
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@jym626, probably not, as long as the son receives survivor benefits +/or SSI. The premiums will be deducted from the monthly annuity.
Best for parent to check with OPM to be sure appropriate documentation of disability is in order.
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@HImom ?
But we have an elderly family member whose husband was a federal employee, and they had the great health coverage benefit including retirement. The husband died, and the wife is still covered.
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I am in that exact situation - surviving spouse covered by FEHB, only because I was covered under employee + family (under 26 y/o was also covered) at time of death.
But there are parameters to be deemed a ‘disabled’ dependent and they have to verified beyond the spousal documentation or they will age out at 26.
Best to check with the employees agency or OPM.
The disabled dependent is 38 and still on the insurance, so guess they will be ok.
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The disabled dependent can stay on the surviving spouse’s coverage if s/he receives enough annuity to cover the premium, otherwise a/he has to work with the insurer about how to pay premiums.
Double-check with your insurer and HR that this info remains correct.
This is for the federally funded retiree health insurance?
If significantly disabled, how does this person navigate this? Can this somehow be set up with the federal government in advance?
The federal insurance program renews annually with options. Nothing can be permanently determined.
If the insurer remains active in the following year, one can opt to do nothing to have the same coverage continue, albeit at the new year’s premium.
If the insurer no longer offers coverage, or the insured moves out of area of service, they would need to find a policy suitable from what is offered.
If there is a significant disability, hopefully, there would be a guardian in place to navigate the details. Also with significant disability, SSI may be invoked which I believe would activate Medicaid.
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Medicare, not Medicaid.
No, Medicaid until age 65, when Medicare activates.
MEDICAID.
In most States, if you are an SSI recipient, you may be automatically eligible for Medicaid; an SSI application is also an application for Medicaid. In other States, you must apply for and establish your eligibility for Medicaid with another agency.
[
SSI and Eligibility for Other Government and State Programs
](Understanding SSI - SSI and Eligibility for Other Government and State Programs)
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My in laws had a similar situation and it did not cover the surviving spouse. I’m not sure if this was because of an election they’d made or because they had both worked or something else. Definitely worth looking into.
A relative who has a spouse on the federal retirement health insurance was told that the spouse will remain covered if he predeceases her. The spouse also has a survivor’s benefit under the pension.
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