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Getting ready to retire? A look at Medicare for High Option members

If you are going to retire sometime in the next year, now is a good time to start learning about Medicare. This is also a good time to learn more about how, as a member, your APWU Health Plan High Option works with Medicare.

Medicare Basics

Medicare is a federal insurance program for people 65 and older. Medicare is made up of four “parts.” Each part helps pay for certain services and also includes certain costs you may need to pay. Here is a simplified overview of Parts A, B, C and D and the purpose of each.


Basic Medicare Coverage
– also called Original Medicare
PART A
Hospital insurance
PART B
Medical insurance
Allows you to go to any doctor, hospital, skilled nursing facility
or outpatient clinic that accepts Medicare.
Covers mostly inpatient care:
  • Hospitalization
  • Some costs for a skilled nursing facility or home health care
  • Hospice
Costs:
Most federal employees and retirees are entitled to premium-free Part A.
Covers mostly outpatient care:
  • Doctor visits
  • Outpatient hospital
  • Home health care not covered by Part A
Costs:
You pay a premium every month and must meet a deductible. You will also need to pay a percentage for most doctor services. This is usually 20%.
You can add these if you want

PART C
also called Medicare Advantage
PART D
Prescription drug coverage
Medicare-approved private health plans that have contracts with Medicare. Usually, you must use certain providers.
Covers:
  • All of the same things as Part A and Part B
  • May include prescription coverage
  • May include coverage for vision, hearing and dental
Costs:
Varies with each plan.
Prescription drug coverage. You must join a plan approved by Medicare
Covers:
  • Prescription drugs
Costs:
You will pay a monthly premium, and must meet a deductible. You will also need to pay either a set amount per prescription (copayment) or a percentage of the cost (coinsurance).

The good news:
APWU Health Plan offers a Medicare Advantage plan for High Option members.

The good news:
As an APWU Health Plan member, there is no need for you to enroll in Medicare Part D.

More about Medicare and your High Option plan