Healthcare News

Updated 10/29/2017

Some of the 2018 Intel Retiree Health benefits are changing. For a quick overview read this article

If you are under age 65 and not yet eligible for Medicare, the new 2018 IRMP Cigna High Deductible Health Plan (HDHP) may be right for you. Here are some of the highlights of the plan: Intel chose not to increase IRMP premiums for 2018. Instead they converted to a higher deductible plan. Under this plan, you pay 100% of the actual cost for medical services and covered prescriptions until you meet your annual deductibles. After your annual deductible has been met, you pay only 10% of in-network cost (co-insurance) until the maximum out- of- pocket amount has been met. Anything after that is at no cost for the insured.
So, in summary even though the IRMP annual deductible increased, the maximum out-of-pocket decreased, the co-insurance percent decreased, and best of all the premium stayed the same.
If you are over age 65 and Medicare eligible, the IRMP plan’s coverage amounts did not change, however; if you choose the IRMP Cigna Indemnity with Rx (includes prescription drug coverage) the premium increases 14%
Additional retiree information on these IRMP Health insurance plans as well as other retiree benefits such as SERMA, Vision (VSP), Dental (Met Life) and access to a HSA can be found in the 2018 Annual Enrollment Guide mailed to your home address on 10/23/17.
For more detailed information about Intel retiree health benefits please go to the official Intel web site at https://www.intel.com/content/www/us/en/employee/intel-retirees.html

Is your COBRA coverage about to end?

Be sure you know how age, health, finances, and enrollment dates impact your choices when you look for healthcare insurance.

These benefits are for US official Intel retirees only.

What should retirees consider when looking for Healthcare Insurance?

When your 18-month COBRA coverage is coming to an end and you are thinking about your future healthcare insurance options, consider these four things:

Age: Are you Medicare-eligible or will you be under 65?

Health issues: Do you have pre-existing medical conditions or a lot of health issues?

Financial situation: How much can you afford to pay in monthly premiums for health insurance coverage?

Enrollment dates: How does your COBRA end date match up with the enrollment periods for Medicare, the Affordable Care Act (ACA), or the Intel Medical Plan (IRMP)?

Knowing the options can help you make the best choice for your situation.

Advice from IRO

U.S. retirees asked us for help understanding their options. The Intel Retiree Organization offers this information to help you plan ahead. It’s come from retirees who have gone through the process of getting healthcare insurance after COBRA. Disclaimer:  The IRO Health and Benefits committee created this document based on personal experience, the MyHealthBenefits website for Intel information, and the Medicare.gov website. It is our best effort to interpret and assist. However we are not the experts, and we encourage you to contact the appropriate resources to validate your individual situation and impact.

Planning ahead for healthcare

IRO recommends that you let your COBRA run its full 18 months, especially if Intel is paying your COBRA.

Many of you will get the Annual Enrollment notice soon. If your COBRA is not yet running out and you are paying for your COBRA, we suggest you do a cost-benefit analysis of your COBRA plan versus the cost of an alternate plan, purchased through the Health Insurance Marketplace. Under the Affordable Care Act (ACA), you might qualify for tax credits that can lower your monthly premiums and for lower out-of-pocket costs. Such credits depend on your household size and income. Alternatively, you can look for insurance in the individual market, or you can purchase coverage under IRMP through Intel, or you can go on a spouse’s plan. Choose the coverage that makes the most sense for you. Be sure that you are accepted by the new plan before you stop COBRA coverage. You don’t want to have a gap in coverage between COBRA and your enrollment in a new plan.

Medicare has penalties for not signing up on time. You must sign up for Medicare at age 65. IRO suggests that you contact the office of State Health Insurance Assistance Programs (SHIP) for your state, to understand your transition from COBRA to Medicare. Call SHIP before you reach age 65, if possible. (See Individual Counseling below.)

COBRA termination and Insurance plan enrollment dates

IRO does not recommend ending your COBRA coverage early outside the Open Enrollment periods of the Healthcare marketplace.

Be aware of the following enrollment periods:

  • Medicare—October 15 to December 7
  • IRMP—November 1 to November 30
  • Health Insurance Marketplace—November 1 to December 15

You want to transition during open enrollment dates for ACA Health Insurance Marketplace and make your choice of healthcare insurance within the window to sign up for IRMP and your Medicare choices within the open enrollment period for Medicare.

If your COBRA coverage ends outside of the open enrollment dates for the Healthcare Marketplace, a.k.a. the exchange, you qualify for a Special Enrollment period, allowing you to enroll in a private health plan through the marketplace.

Early exit from COBRA

Early termination is not considered a special enrollment event that would allow you to enroll in coverage through the Healthcare Insurance Marketplace, which includes individual insurance. Also, another employer might not allow you to enroll in their health plan.

For example, should you choose to drop three months of Intel-paid COBRA, you will not qualify for Special Enrollment in the Marketplace, and possibly another employer’s health plan for the remainder of the 18-month COBRA period. You would have to wait for the next open-enrollment period.

From the U.S. Department Of Labor

According to the research conducted by IRO, including a conversation with the U.S. Department Of Labor, you may be able to purchase Individual health insurance at any time (when on COBRA) through a broker or directly from a Health Insurance Company in your state, but we also found most insurers have prohibited enrollment outside the open enrollment window for the marketplace. They do so to prevent insurers from having to take on the risk and costs of a new policyholder that waits until they suffer a major medical issue before seeking guaranteed issue insurance coverage. The Dept. Of Labor strongly recommends that you verify acceptance for an individual health insurance plan before you cancel your COBRA coverage early.

Pre-Medicare options (under age 65)

If you are not yet Medicare-eligible, you have four options:

Option 1: Pre-Medicare IRMP. The Intel Retiree Medical Plan is available to Intel retirees of any age up to age 65. Looking ahead to the likely cost of 2018 premiums, IRO compared premium costs for IRMP with those of plans that you might purchase from the healthcare exchanges in Oregon or California. When you compare gold plans that pay 80% of treatment, we found the cost of premiums to be similar. The benefits of the IRMP plan are comprehensive coverage with relatively low deductibles and maximum out-of-pocket limits. It’s a Cigna plan.

Option 2: The open market (individual market). You can search and shop for a policy on your own through the Internet or you can request the assistance of a licensed health insurance broker/agent, whose fees are paid by the insurers. You may also find appropriate healthcare insurance that is available through a relationship with organizations such as university alumni associations, professional groups like IEEE, civic groups (Chamber of Commerce) or purchasing memberships (Costco).

Option 3: Federal Health Insurance Marketplace (ACA Exchange). You might benefit from ACA coverage if you qualify for financial subsidies to offset the premium and co-payment costs. Such offsets depend on the size and income of your household. All plans meet the ACA minimum essential coverage requirement (bronze, silver, gold, and platinum) and have generally higher deductible, co-pay, and maximum out of pocket limits. While premiums for these plans are competitive, they are not necessarily lower than what you can get on your own through option 1 or 2.

Option 4: Another employer’s plan. If your spouse is employed, you might be able to join that company’s plan or you might choose to work for another employer and join their plan.

The Health Insurance Marketplace (ACA Exchange)

IF your COBRA is fully exhausted, and you are looking for healthcare insurance from private insurers, you can find options on the ACA Health Insurance Marketplace.

All healthcare plans that were introduced after 2014, in both the group and individual markets, conform to the regulations set forth in the Affordable Care Act (ACA or Obamacare). These plans must include coverage for ten essential benefits with no lifetime or annual benefit maximums, and the plans must adhere to the consumer protections built into the law. One of the consumer protections is the pre-existing condition requirement: no insurance plan can reject you, charge you more, or refuse to pay for essential health benefits because of any condition you had before your coverage started.

Medicare options (over age 65)

If you are age 65 and older, you should explore Medicare, Part A (hospital) and Part B (medical). You sign up for Medicare coverage options through the Social Security Administration. It takes some effort to get familiar with the terms and plans. See “Resources for more detailed information” for links to websites with detailed information.

After reading this basic material, you make the following choices:

Decision 1: Original Medicare or Medicare Advantage Plan. With Original Medicare, Parts A and B, you can choose your own doctor (as long as they accept Medicare). Original Medicare can include supplemental insurance or IRMP:

  • Often retirees choose supplemental plans, often called a Medigap, plan to reimburse them for un-reimbursed Medicare costs when they choose Original Medicare.
  • IRMP for the Medicare-eligible retiree coordinates with Original Medicare, with or without prescription drug coverage, and is an alternative to Supplemental Insurance. To understand how the IRMP indemnity plan works, see your Annual Enrollment materials.

Medicare Part C, or Medicare Advantage, plans are run by private insurance companies but regulated by the government. They cover original Medicare parts A and B plus additional services, and most of them include prescription drug coverage (Part D).

Decision 2: Prescription drug coverage (Part D). If you choose Original Medicare, and you want prescription drug coverage, you must join a Medicare Prescription Drug Plan. You usually pay a monthly premium. Private companies run these plans with approval by Medicare. Note: IRMP with Rx satisfies the requirements of a Part D plan; most Medicare Advantage plans include prescription drug coverage. See “How to get drug coverage” on the Medicare website for more information.

Decision 3: Supplemental (Medigap) coverage. If you choose Original Medicare, you might want additional coverage to help pay some of the healthcare costs that Original Medicare doesn’t cover, such as co-payments, co-insurance, and deductibles. You can choose to buy a supplemental policy from a private company to cover these costs. You can also choose the IRMP indemnity plan (not a supplemental plan).

IMPORTANT NOTE: When choosing between Original Medicare and Medicare Advantage, you should be aware of the “guaranteed issue right,” a provision that you can buy any supplemental (Medigap) policy offered in your state, regardless of your medical condition, available only when you first become Medicare eligible. After the initial enrollment period, you might not be able to buy a Medigap policy, and if you are, it may cost more. The Medicare website explains guaranteed issue rights.

IF you think you want to try Original Medicare with a Medigap plan, make sure that you choose that plan when you have guaranteed issue! Doing so means that you can enroll in Medicare Part A and Part B (Original Medicare) and purchase a Medigap or supplemental policy. With this option, you go to your choice of doctors, hospitals and other providers that accept Medicare and your supplemental plan.

If you originally chose an Advantage plan (Part C) during your guaranteed issue period you MAY be able to make a change later, during open enrollment. However, the insurance carrier can charge you a higher price for the supplemental insurance, if it was not issued under guaranteed issue, and you could be turned down.

Your cost sharing is lower (or included) if you’re in a Medicare Advantage Plan. You can’t use (and can’t be sold) a Medigap policy if you’re in a Medicare Advantage Plan or IRMP.

Possible effect of ACA changes

Changes to the Affordable Healthcare Act could affect much of this information, in ways the IRO benefit committee cannot predict at this time.

FAQs for Medicare

How much does Medicare cost?
In 2017, the standard Part B premium amount is $134; the premium can be higher depending on your income. However, most people who get Social Security benefits pay less than this amount ($109 on average).

You usually pay a monthly premium for your Medicare Advantage plan, in addition to your monthly Part B premium.

You may pay a co-payment or co-insurance for covered services. Costs, extra coverage, and rules vary by plan.

What’s a Medigap plan?
Medigap, also called Medicare supplement insurance or Medicare supplemental insurance, refers to various private health insurance plans sold to supplement Medicare in the United States. —Source: Wikipedia

What’s Medicare Advantage?
These plans include both Part A (Hospital Insurance) and Part B (Medical Insurance). Private, government-approved companies offer them and Medicare pays these companies to cover your Medicare benefits. Sometimes they are called “Part C” or “MA Plans.”—Source: Medicare.gov

Who provides coverage under Medicare Advantage or Medigap?
Private insurance companies approved by Medicare. See the “Medigap and Medicare Advantage plans” page to learn more about how Medigap policies work with Medicare Advantage plans.

How do you choose your providers in a Medicare Advantage Plan?
You may need to use healthcare providers who participate in the plan’s network.

Where can I learn more about how Medicare Advantage plans work?
See Medicare Advantage Plans on the medicare.gov website.

Resources for more detailed information

Federal web pages
Read “Getting Started with Medicare” to find out about the basic parts of Medicare, when you can get Medicare, and the choices you need to make.

For further help with understanding the choice between Original Medicare and Medicare Advantage, see “Your Medicare coverage choices” on the medicare.gov website.

You can find an index to information about Medicare on their website.

See “Enroll in or change plans with a Special Enrollment Period” for information about special enrollment periods, when COBRA is fully utilized.

For state-specific information on purchasing individual healthcare insurance on the open market, you can click on your state in this list.

Consult “Private plans outside the Marketplace outside Open Enrollment” to read about purchasing healthcare on the individual market.

The U.S. Department Of Labor’s web site provides a great reference on COBRA issues and questions.

Individual counseling
You can call the Aon Retiree Exchange at 877 466 9236 to set up an appointment and ask about your healthcare coverage options in the health insurance marketplace. This group administers Intel’s healthcare insurance for employees and retirees.

State Health Insurance Assistance Programs (SHIPs) that offer local, personalized counseling and assistance to people with Medicare and their families. They can guide you through the process. To take advantage of help, you can find SHIPs contact information for your state’s website.

Intel sources of information
To read the Summary Plan Description for COBRA, go to MyHealthBenefits and log in. Then you navigate to “Plan Information,” and find the COBRA Continuation Coverage plan description.

To read all about IRMP and SERMA and understand what’s covered by the IRMP insurance and the costs, consult your Annual Enrollment Guide, which was mailed to your home at the end of October. In the section “My Health Benefits,” look for “Plan Information: IRMP and SERMA Summary Plan Description.”

Senior Housing Needs and Options
If you are looking ahead to your Senior Housing needs and options, there are several important factors to consider such as your finances (how much you can afford to pay out of pocket), your health condition (do you need help with activities of daily living, and if so, do you have long Term Care insurance to help pay the cost), and your preferred location.

You might find the following 2 links to be helpful in plotting your course:US Department of Housing and Urban Development information for Senior Citizens http://portal.hud.gov/hudportal/HUD?src=/topics/information_for_senior_citizens  and Senior Advisor at https://www.senioradvisor.com/.

Intel Retiree Organization’s recommendation is to do the research,  and get some sound advice in order to avoid some serious pitfalls such as described in the following article http://www.mercurynews.com/news/ci_29627978/alameda-county-mans-move-from-licensed-care-home.

Health Care Costs in Retirement
An American hoping to retire soon can look forward to spending more than a quarter of a million dollars on health care over the rest of his life. People who are young now will probably spend a lot more than that.

Health Insurance Terms… Getting Ready for Open Enrollment (9/27/16)

When you are making health insurance decisions during the upcoming open enrollment, there are some terms you need to understand in order to compare plans. As an Intel employee you probably didn’t have to think much about deductibles, co-pays, maximum out-of-pocket, etc. If you were like me you just paid what was owed to the medical provider and didn’t think too much about it. Now that you are retired you do need to think about these factors in order to make the most financially proper decision about which plan to select for your coverage. It doesn’t matter whether you are on Medicare, IRMP, or buy your Health Insurance in the open market, these terms apply to all plans.  Go to this link on Healthcare.gov (the federal healthcare exchange web site) to read more https://www.healthcare.gov/ choose-a-plan/your-total- costs/. The general reality for all plans is the higher the monthly premium, the lower the out-of-pocket costs will be.

– Long-Term Care Health Insurance
(5/3/2013) Here are the most current Q&As on long-term care from Intel.

(5/3/2013) Relevant articles:
– Preparing for Long-Term Care: Besides the information on our website, a recent article in the New York Times describes the expense and emotion of preparing for long term care.

  • Ailing Long-Term Care Insurers Share their Pain:  Suffering long-term care insurance providers are finding new ways to share their pain with customers. A recent article describes how to cope

– Prescription Benefits
For retirees using IRMP with prescription benefits (Cigna and Anthem Blue Cross Plans):
Prescription benefits are now administered by Express Scripts. Find out more at this link.

 

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