Health Benefits in Retirement (Overview)

Are you planning to retire in the next year? This video from the Wisconsin Department ofEmployee Trust Funds, or ETF, will help ensure a smooth transition of your health benefitsinto retirement.

Most of the information provided in this videoapplies to state, University of Wisconsin, and local employees.

Where there are differences for local employees, we will point them out.

Meet Maria.

She is 61 years old and nearing the end ofher state career after serving Wisconsin residents for 25 years.

She recently received her retirement estimatefrom ETF, and now also needs information about her health benefits in retirement.

Maria wants to know:Can I continue the health insurance I have today? I already paid money towards my deductibleand out-of-pocket limit this year.

Do these limits reset once I stop working? If I cancel coverage, can I re-enroll later? Can I change my health plan once I retire? If my husband keeps working, should we switchto his insurance? What if I want to buy different health insurancein retirement? Let's start addressing these important questions.

Maria's employer-based health insurance coverageand plan design options will not change due to retirement.

This means Maria, her spouse and other covereddependents will still have access to the same doctors and other health care providers inher plan's network.

Also, any money they have already paid towardsthe deductible or out-of-pocket limit will carry forward through the end of the calendaryear.

Maria can keep her health insurance becauseshe is currently covered.

She will remain covered, as long as she paysher premiums.

If Maria were not currently covered, she couldtake steps before she retires to become covered and protect her accumulated sick leave balance.

Contact your employer benefits specialistif you are in this situation.

Maria can cancel her coverage at any time.

Cancellation is effective the 1st of the monthafter ETF receives the written request.

As a state employee, unless Maria cancelsher coverage, it automatically continues into retirement.

If Maria were a local employee, such as aschool teacher in a district covered under the Wisconsin Retirement System, she wouldneed to complete a form with her employer benefits specialist to continue coverage intoretirement.

If she decides to cancel coverage, she couldreenroll during the annual It's Your Choice open enrollment period in the fall.

Maria wants to know if she can change healthplans.

Retirement alone does not provide an opportunityto change health plans.

However, there are certain life events thatallow for plan changes at any time, outside of the annual It's Your Choice open enrollmentperiod.

Keep in mind, there are usually some programchanges each year that affect all employees and retirees.

Maria should carefully review the updatedhealth benefits information during the annual It's Your Choice open enrollment period inthe fall.

This is when she will learn about any changesin plan options, benefits, or available health plans and providers.

Looking a few years down the road when Mariaturns 65, her plan options will change.

She will need to enroll in Medicare.

Check out the New to Medicare video for moreinformation.

Oh, Maria also asked about switching to herhusband's health plan.

Since her spouse is still working, they canswitch to his health plan.

Before doing so, they should each talk totheir employer benefits specialists, as there are some things to think about.

For example, they will need to pay attentionto his plan's enrollment dates.

They will not have an automatic enrollmentopportunity solely because Maria is cancelling her coverage.

Finally, Maria wonders if she should explorecoverage options besides those offered by her employer.

She can always review options available inthe health insurance marketplace.

If she chooses a plan from the marketplace, she should consider how the benefits and costs compare to plans available through her employer.

She will also need to be aware of the openenrollment dates.

If Maria decides to cancel her current coveragethrough her employer, it will be important for her to protect, or escrow, any accumulatedsick leave credit Local employees do not have sick leave credits, but may have other resourcesavailable through their employer to help pay for health benefits in retirement – a benefitsspecialist will have all the details.

Maria feels reassured now that she knows moreabout her health benefits in retirement, and we hope you do, too.

If you do have questions before retiring, contact your employer benefits specialist.

After retiring, contact ETF.


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