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Learn About Medicare & Social Security

Planning for Medicare

The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs the Medicare Program. Original Medicare is a low-cost government insurance program that guarantees access to health insurance for people aged 65 and older and younger people with certain medical disabilities, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). It pays for many health care expenses but not all. Medicare covers its share of an approved amount and you pay the rest through deductibles and coinsurance. Original Medicare is made up of two parts:

  • Medicare Part A hospital insurance covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery and home health care. Most people do not pay a premium for Part A.
  • Medicare Part B covers doctor and other health care providers’ services, outpatient care, lab tests, durable medical equipment and supplies, ambulance services, home health care, and some preventative services. You will pay a monthly premium for Part B.

In addition to Original Medicare (Parts A and B), you may consider finding added coverage for more comprehensive benefits. Original Medicare doesn’t cover everything. Original Medicare alone does not limit your annual out-of-pocket expenses and has gaps in coverage that may result in direct expenses to you. For example, Original Medicare (Parts A and B) does not include prescription drug coverage, so you will need to purchase a prescription drug plan (Part D) if you want coverage for prescription expenses. Part D plans are offered by private Medicare-approved insurance companies and provide coverage for prescriptions drugs as determined by Medicare. This coverage may be included as part of many Medicare Advantage Plans (Part C) and is also available as a standalone policy to complete your coverage with a Medicare Supplemental plan. The difference between Medicare Advantage Plans (Part C) and Medicare Supplemental Plans is as follows:

  • Medicare Advantage Plans (Part C) are offered by private Medicare-approved insurance companies and provide the same coverage as Parts A and B and may offer additional coverage such as Prescription Drugs (Part D), Dental, Vision, and/or Hearing care, as well as additional benefits that provide healthy lifestyles. Medicare Advantage Plans (Part C) carry a monthly premium.
  • Medicare Supplemental Plans are offered by private Medicare-approved insurance companies and are designed to pay many of the costs not paid by Parts A and B. Medicare Supplemental Plans carry a monthly premium.

Standalone dental, vision, and hearing care coverage is also available.

You must be enrolled in Original Medicare through the Social Security Administration before you can start adding to your coverage. You can sign up by: 

If you are approaching age 65, you can enroll in Original Medicare during the 7-month Initial Enrollment Period (IEP): the 3 months before your 65th birthday month, your birthday month itself, and the three months after your 65th birthday month. People who are Medicare-eligible because they’re on Social Security Disability are subject to different Medicare enrollment rules.

You can learn more about Medicare by:

  • Visiting medicare.gov
  • Calling 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048
  • Contacting a private Medicare-approved insurance company (see Find a Medicare Advantage or Supplemental Plan for more details)

When Active Coverage Ends Under the Trinity Health Corporation Welfare Benefit Plan

When your employment ends, in most cases, coverage under the Trinity Health Corporation Welfare Benefit Plan ends the last day of the month in which your employment ends. For more information on Eligibility for Coverage Under Trinity Health Corporation Welfare Benefit Plan, visit https://hr4u.trinity-health.org or contact your local benefit representative.

If you and/or your family member previously waived Medicare Part B because you were covered by Trinity Health’s plan and you are now applying for Medicare Part B coverage during a Special Enrollment Period, you can request the CMS-L564 Request for Employment Information form be completed on your behalf by Trinity Health. Please CLICK HERE to submit your request electronically or contact your local benefit representative.

If you are receiving health care continuation provided by a severance policy, separation, employment or similar agreement you can enroll in Medicare. Because your Trinity Health coverage is no longer based on your active employment, Medicare would be your primary coverage, and the Trinity Health Corporation Welfare Benefit Plan would provide secondary coverage.  To find out when you should sign up to avoid penalties, connect with the Centers for Medicare & Medicaid Services (CMS) or the Social Security Administration.

Continuing Coverage Under the Trinity Health Corporation Welfare Benefit Plan Past Age 65

Active, benefits-eligible colleagues may continue their Trinity Health Corporation Welfare Benefit Plan past age 65. For more information on how the Trinity Health Corporation Welfare Benefit Plan coordinates with another health care plan, visit https://hr4u.trinity-health.org or contact your local benefit representative. For additional resources on deciding whether to enroll in Part A and Part B when you turn 65, if you have health insurance from an employer, visit the Medicare site.

Medicare Eligibility and Your Health Savings Account (HSA)

As you approach Medicare eligibility, please be aware of some important rules regarding Medicare and your health savings account (HSA). You can be Medicare eligible and still contribute to your HSA beyond age 65, as long as you have postponed applying for Social Security payments and Medicare benefits. Once you are enrolled in any part of Medicare, you will not be eligible to contribute to an HSA in the months following your Medicare effective date. A pro-rated contribution must be determined for the year in which Medicare becomes effective. For more information on Medicare Eligibility and your HSA Under Trinity Health Corporation Welfare Benefit Plan, visit https://hr4u.trinity-health.org or contact your local benefit representative.

What Are Medicare Advisors?

Medicare advisors (sometimes called Medicare brokers, Medicare agents, or Medicare consultants) can be independent sales agents representing one or multiple different Medicare plan providers (insurance companies), or they can be insurance brokers who work on behalf of a Medicare beneficiary. A good Medicare advisor will gather data on Medicare plans from different carriers, review the details of the plans with you, explain the costs associated with each plan, and help you enroll into a plan. They may help you find a plan that is accepted by your preferred pharmacy and providers. Trinity Health’s Medicare Advantage plan backed by MediGold, and Alight Retiree Health Solutions are some examples of Medicare Advisors.

There are also some non-profit organizations that serve as Medicare advisors. These organizations provide free assistance with Medicare questions, enrollment help, and more. A few examples of such organizations are:

Medicare.gov

The official government website for Medicare publishes information about how Medicare works, what it covers, when to enroll, Medicare costs, how to buy private insurance policies that can fill in coverage gaps, and more. Beneficiaries may contact CMS Medicare advisors by phone or live online chat to ask Medicare questions and request information.

Social Security Administration

Even though Centers for Medicare & Medicaid Services (CMS) runs the Medicare program, the Social Security Administration handles Medicare enrollment. The agency can help with questions about Medicare enrollment and eligibility; applying for the Part D prescription drug Extra Help program, which provides financial assistance for Medicare beneficiaries with low income and assets; and contesting Medicare’s high-income premium surcharges.

State Health Insurance Assistance Program (SHIP)

Each state has its own State Health Insurance Assistance Program, or SHIP. These programs provide free, one-on-one counseling and assistance to beneficiaries, their families and caregivers to help people better optimize their benefits and care.

Medicare Rights Center

This national consumer service organization provides counseling, advocacy, and educational programs to ensure affordable health care for older adults and those with disabilities.

AARP Medicare Resource Center

AARP’s Medicare Resource Center can give you an overview of how Medicare works, news on the latest changes and developments, and answers to many of your Medicare questions. Among the other resources you will find step-by-step tutorials on how to use Medicare’s plan finder and on-demand webinars to teach you about Medicare.

Social Security Retirement Benefits

The Social Security Retirement benefit is a monthly check that replaces part of your income when you reduce your hours or stop working altogether. You may be eligible for social security benefits if you:

  • Reach retirement age and retire
  • Can’t work because of a disability
  • Lose a spouse (or a young child loses a parent)
  • Have difficulty paying for essentials like food, clothing, and a home

 You can see if you are eligible and learn how to apply by:


 

Understanding Medicare: Common terms and acronyms

We've put together a list of definitions for common Medicare terms and acronyms you will come across as you search for a plan.

Check the Medicare Glossary

Disclaimer:

The information provided on this website is designed to assist you with understanding your options under Medicare and for supplemental retiree healthcare coverage. It is only an overview and is not intended to be a comprehensive description of any benefit plans that may be available to you. While every attempt is made to keep this information correct and up to date, nothing contained herein is to be construed as a guarantee and/or medical, legal, tax or other professional advice. This website may also include links to external websites operated by third parties. Trinity Health is not responsible for and makes no representations or warranties concerning the accuracy of any information or content provided through such external links. Medicare has neither reviewed nor endorsed this information.