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Medicare Study Guide

If transitioning to Medicare soon, you have a lot of homework to do -- whether receiving HP, HPI, or HPE benefits or not.

Advice and reference info from members. (Updated November 3, 2017.) 

Page updated often -- use browser refresh button to display latest version.

This topic is covered in the HPAA's US Benefits Forum.

Overview of US health coverage issues: http://www.hpalumni.org/health

See also Annual Enrollment for US retiree and COBRA health coverage..

Contact the HPAA volunteers: info@hpalumni.org

(Note on pdf files: If you click on a pdf file and it doesn't come up automatically in your browser, go to http://get.adobe.com/reader to get a free, genuine copy of Adobe Reader for Windows, Mac, or Android. Be sure to uncheck the pre-checked boxes that give Adobe permission to install unrelated software or change your default browser.)


For everyone -- whether receiving HP, HPI, or HPE benefits or not


Step 1. Learn the basics

Official Medicare site:

- Bookmark and explore the Official Medicare site:  http://www.medicare.gov   (Note that official-looking medicare.com site that comes up in Google searches is operated by an insurance sales agency.)

- Download the excellent "Medicare and You" booklet -- https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf -- from the official Medicare site. Two key pages: A flowchart on page 17 explains Original Medicare + Supplemental vs Medicare Advantage plans. A table on page 82 explains the Supplemental plans -- A through N. Even if you have a paper copy, it is very helpful to use Adobe Reader's search feature to find specific words or phrases in a pdf file. (Depending on the document and your setup, either hit the F3 key to search for words or phrases -- or hover over the lower edge of any page. In the hover case, you will see a popup. Click on the "swirl" icon at the right of the popup to get the Adobe Reader toolbar.)

- If you don't sign up for each of the various elements of Medicare when you are first eligible, you generally have to pay a late enrollment penalty for years. (Covered throughout the "Medicare and You" booklet.)

AARP Bulletin site. Membership in AARP is not required to access these excellent articles from the October 2017 issue of the AARP's member newspaper:

- Key Medicare dates if already on Medicare or new to Medicare
https://www.aarp.org/health/medicare-insurance/info-2017/timeline-medicare-enrollment.html

- How to choose a Medicare plan
https://www.aarp.org/health/medicare-insurance/info-2017/choosing-medicare-plan.html

- Table giving pros and cons of Original Medicare (Parts A and B), Advantage (Part C), and Supplemental "Medigap" (which covers gaps in Original Medicare)
https://www.aarp.org/health/medicare-insurance/info-2017/understanding-medicare-plans.html

- Supplemental "Medigap" policies help pick up the costs not covered by original Medicare.
https://www.aarp.org/health/medicare-insurance/info-2017/choosing-right-medigap-plan.html

Employer Medicare plans such as HP's -- are "group" plans that have been customized for the specific employer. They don't have to match the government specifications for Advantage or Supplemental plans, making comparisons with individual, standard open-market Medicare plans difficult. You have to carefully analyze the features as they apply to your specific situation (for example medications or pre-existing conditions.) Key pages from the official Medicare site:

- Retiree insurance. "If you're retired and have Medicare and group health plan (retiree) coverage from a former employer... "5 things to know about retiree coverage"
https://www.medicare.gov/supplement-other-insurance/retiree-insurance/retiree-insurance.html

- Employer coverage (if still employed.) "Even if you have coverage through a current or former employer, you still may need to make some important Medicare enrollment decisions. It’s important to understand how your current coverage works with Medicare before making any decisions." Three choices: "I have employer coverage and: I'm turning 65 or I'm over 65 or I'm under 65 and have a disability."
https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/employer-coverage/i-have-employer-coverage.html#collapse-5568


Step 2. Limitations and traps on official Medicare site:

There are limitations and traps related to pre-existing conditions, and when changing between employer-provided, retiree, Advantage, and Supplemental (Medigap) coverage. Here are other key pages on the official Medicare website covering limitations and traps:

- Supplemental (Medigap) plans:
"Choosing a Medigap Policy" Especially note the section on Guaranteed Issue -- pages 21-24.
https://www.medicare.gov/pubs/pdf/02110-Medicare-Medigap.guide.pdf
"8 things to know about Medigap policies"
https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html
"Guaranteed issue rights. Rights you have in certain situations when insurance companies are required by law to sell or offer you a Medigap policy even if you have health problems (called 'pre-existing conditions.')"
https://www.medicare.gov/find-a-plan/staticpages/learn/rights-and-protections.aspx

- Advantage plans:
"13 things to know about Medicare Advantage Plans"
https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/things-to-know-medicare-advantage-plans.html

- Changing plans:
"Medigap [Supplemental] & Medicare Advantage Plans"
https://www.medicare.gov/supplement-other-insurance/medigap/medigap-and-medicare-advantage/medigap-and-medicare-advantage-plans.html

- Comparing open-market plans:
You can compare quality and performance of Medicare plans on the official Medicare website: 
https://www.medicare.gov/find-a-plan/

If you have found an especially helpful page on the official Medicare site, please pass the word via an email to info@hpalumni.org


If receiving HP, HPI, or HPE benefits


Step 3. Read the HP Enrollment Guide very carefully:

The 2018 Guide has color-coded bands across the top of each page:

- For everyone -- white or gray band.

- Medicare eligible -- orange band.

- Not yet Medicare-eligible -- purple band.

- Families with both Medicare-eligible and non-Medicare-eligible members -- red band.

- Be sure to read the critical info at the end of the booklet. (Called "Important reminders" -- but some of the points may be new to you.)

Benefits Enrollment Guide: http://www.hpalumni.org/2018HPIEnrollmentGuide.pdf  (Even if you have the printed booklet, it is very helpful to download the file so that you can search this complex document using the pdf reader on your system. For example, search for "Medicare" in the Enrollment Guide.)


Step 4. Find the appropriate Medicare sites for your state:

- State Health Insurance Assistance Programs. State-specific SHIP websites with information about local, personalized counseling and assistance to people with Medicare and their families. SHIPs can help you with things like: Your Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance. Complaints and appeals. Joining or leaving a Medicare Advantage Plan (like an HMO or PPO), any other Medicare health plan, or Medicare Prescription Drug Plan. Highly recommended by HPAA members.  https://www.shiptacenter.org

- Medicare Savings Programs. If you have limited income and resources, you can get help from your state paying some or all of your Medicare premiums, deductibles, and coinsurance. https://www.medicare.gov/Contacts/#resources/msps

- State Insurance Departments. Information about Medicare Supplement Insurance (Medigap) plans sold in the state. https://www.medicare.gov/Contacts/#resources/sids

Links on the official Medicare site to other helpful contacts: https://www.medicare.gov/Contacts


Step 5. HPAA Medicare Webinar (From 2014 -- but the fundamentals have not changed.)  

There are several expensive traps in Medicare -- one of which could cost you for years. They are well explained in the video from HPAA's October, 2014 Medicare webinar.

- Lifetime costs for missing deadlines.
- Premium depends on the last tax return available to Medicare, which may be a lot higher than your actual income.
- In-network vs. out-of-network.
- Physically in a hospital but not technically "admitted" -- a potentially very expensive trap.
- The deductible, coinsurance, and drug coverage differences between the various alternatives.

Watch the slides-and-audio video of the WebEx conference, including Q-and-A: HPAA Medicare Webinar video   [YouTube, 75 minutes. YouTube detects your connection speed and adjusts the video quality accordingly.]
How to use the video: You may want to download the slides first
-- and then select the key slides to print for note-taking while watching the video. 

Part 1 -- For everyone: Medicare Explained -- with Heads Up Warnings  [First half-hour of the HPAA video ]   Printable slides [pdf, 42 pages, 0.6MB]
Connie Corrales -- from Sourcewise, a non-profit in Santa Clara County.
- Federally funded nationwide Medicare counseling and advocacy in every state.
- Introduction to Medicare.
- Medicare choices and options.
- Heads up! Several expensive traps.

Part 2 -- For those on the Pre-2003 Retiree Program: Medicare for HP Retirees  [28:22 to 51:55 on video]   Printable slides [pdf, 24 pages, 0.7MB]
David Rew -- from the Aon Retiree Health Exchange
- If on Pre-2003 Retiree Medical Program and don't want an HP group plan, the HP reimbursement can only be used to purchase a plan through Aon.
- Aon is compensated by insurance companies; agents not on commission.
- How to prepare; Guaranteed Issue of Coverage varies by state; enrollment and payment options; timeline; going back to the HP group plan.

Part 3 -- Q and A  [51:58 to 01:15:19 on video]

Comments to: editor@hpalumni.org  (WebEx facilities courtesy of First Tech Federal Credit Union.)


Step 6. If on the "Pre-2003" Retiree Program.  (The confusing term "Pre-2003 HP Medical Program" refers to the year in which Hewlett-Packard's US retiree medical program was redesigned -- not the year you retired. Regardless of when you retired, depending on your length of service and other factors, you may qualify for the US "Pre-2003" program. Details: http://www.hpalumni.org/Pre2003 )

Key info on Medicare for HP retirees is located in several sections of the Annual Enrollment Guide: Download the Enrollment Guide from HPAA's Annual Enrollment Page 

HP group PPO Medicare plan. "A national plan offering full flexibility to its members. This plan is not a network-based plan. HP retirees can see any provider who accepts Medicare and the UHC PPO plan. If a provider indicates they accept Medicare but do not accept the UnitedHealthcare Group Medicare Advantage (PPO) plan, the participant should call UHC at 1-877-456-7240, 8 a.m. – 8 p.m., local time, Monday through Friday. TTY users, call 711. This will allow UHC to follow-up with the provider to explain the plan in more detail."
--per HPI US Benefits.

Individual plans from Aon Retiree Health Exchange (ARHE)  Applies only if you and your spouse or domestic partner are both Medicare-eligible.

ARHE is an insurance sales agency that has been selected by HP to market HP-subsidized individual, standard open-market Medicare plans to HP retirees. ARHE is a separate company from Aon Hewitt, which operates the Benefits Centers for HPI and HPE and administers HP's group plans. Members report that employees of each company, understandably, have little or no knowledge of the other company's role or processes.

If you elect to purchase an HP-subsidized individual insurance plan through ARHE, your benefits choice is indicated at the Benefits Center as "Aon Retiree Health Exchange $0.00." You pay directly for your coverage. At the start of the year, HP funds a Retiree Reimbursement Account administered by Aon Hewitt. ARHE automatically submits claims to Aon Hewitt, which reimburses you via monthly direct deposit until the Reimbursement Account is exhausted for the year.

Notes:

- An individual plan is subsidized only if you purchase through ARHE. (With an HP group plan, the HP subsidy is not broken out separately -- it is factored into the price you pay.)

- AARP/UHC Medicare plans are not on the list of available plans from ARHE -- you have to explicitly ask the ARHE agent for the AARP/UHC plans. Check the AARP/UHC website to see what is available in your local area: https://www.aarpmedicareplans.com

- Kaiser individual Medicare plans are not available through ARHE -- group Kaiser Medicare plans are available through the Benefits Center.

- Changing to group plan: "You’ll still have the option to enroll in HP coverage during future retiree benefits enrollment periods if you disenroll from Aon Retiree Health Exchange coverage or have a qualified status change." --Page 2 of the HPI Enrollment Guide

- Because your are buying a standard individual policy via the Aon sales agency. HPI or HPE is out of the picture -- except for providing  the subsidy.

- If you have a problem, contact your Aon Retiree Health Exchange Advisor. If the Advisor can't resolve your problem, they escalate it to Aon's special group of Advocates. Contact the Benefits Center if there are problems with the subsidy payments

There is a confirmation and mop-up cycle after the deadline. "After you enroll in HP coverage, you’ll receive a Confirmation of Coverage in the mail at home in November showing your 2018 HP elections. It's important to review your confirmation and notify the HP Benefits Center immediately if any corrections are needed. If you don't make corrections by December 28, 2017, at 6 p.m. Pacific Time (8 p.m. Central Time), you can't change your HP elections for 2018 unless you experience a qualified status change."
http://www.hpalumni.org/2018HPIEnrollmentGuide.pdf (Enrollment Guide page 7)

If you won't be able to resolve your Medicare situation by the enrollment deadline -- for example, because you can't get an Aon Retiree Health Exchange (ARHE) appointment in time, or your have an application pending for an individual Medicare plan through ARHE -- enroll in the most likely HP plan now and change later if necessary.

ARHE for HP Inc www.retiree.aon.com/hewlettpackard
Toll-free 1-800-975-0355, 7am to 10pm Central Time, Monday through Friday

ARHE for Hewlett Packard Enterprise https://retiree.aon.com/hewlettpackardenterprise
Toll-free 1-844-537-5303, 7am to 10pm Central Time, Monday through Friday

On the ARHE site, you can register and confirm your enrollment appointment -- and prepare for your enrollment phone call:
- Enter your prescriptions -- which has a huge effect on which plans make sense for you.
- Compare plans and put the best alternatives in the shopping cart

If you have a problem, contact your Aon Retiree Health Exchange Advisor. If the Advisor can't resolve your problem, they escalate it to Aon's special group of Advocates.

Contact the Benefits Center if there are problems with the subsidy payments.

Comparing open-market plans:
You can compare quality and performance of Medicare plans on the official Medicare website: 
https://www.medicare.gov/find-a-plan/


Comparing plans:

From our discussions on the HPAA Benefits Forum, of the many factors involved in picking a retiree health plan, there are five key issues:

1. Whether the plan has an annual out-of-pocket maximum -- or a lifetime cap -- you could get wiped out financially by a major health issue.

2. Whether or not you have pre-existing conditions.

3. What medications you currently take -- which can make a huge difference in your cost via co-pays.

4. Other co-pays. For example, the co-pay for hospital stays can vary from zero to hundreds per day.

5. Whether your current doctors -- and the hospitals and specialists they use (such as anesthesiologists) -- accept each plan.

  


Contacts:

See our contact directory: http://www.hpalumni.org/contacts#Medical 

Who to call with medical benefits issues: Who does what? - the HPAA's summary of the roles played by the Benefits Center and each of the many providers -- and how to escalate. 

Health insurance agents. Many ex-HPers do not qualify for an HP health insurance plan -- or, even if they do, have low years-of-service such that they should consider non-HP alternatives. An experienced independent insurance agent licensed to sell health insurance in your state can help you sort through the complexity -- and adds nothing to the cost of the plan you purchase from them.


Medicare Prescription Coverage Letters sent by UHC

- "...your plan sponsor has decided to end your prescription drug coverage"  www.hpalumni.org/UHC-EndDrugCoverage

- "...you may have to pay a Late Enrollment Penalty..."   www.hpalumni.org/UHC-LateEnrollmentPenalty


For more mutual help on these topics and many others, join the HP Alumni Association. You are eligible to join the HP Alumni Association if you were formerly a regular, direct employee of Hewlett-Packard, HP Inc, or Hewlett Packard Enterprise– or have a defined retirement or termination date. Thanks to the HPAA's Supporting Members, there is no charge to join the HPAA.

The Hewlett-Packard Alumni Association is an independent volunteer organization of former HP, HP Inc, and Hewlett Packard Enterprise employees – and current employees in the process of leaving. Operated by former employees who volunteer their time; not officially endorsed or supported.

 

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