Employers and Employees Can Benefit From Understanding Medicare

Medicare only covers several types of medical costs for retirees, not including premiums and deductibles. Experts say it’s time for both groups to learn what that means. 

Many people younger than 65 who are preparing for retirement think Medicare will cover their health care expenses once they retire. But that’s not always the case.

Medicare—which is administered by the Centers for Medicare & Medicaid Services (CMS) and is part of the Department of Health and Human Services (HHS)—is a national health insurance program that began in 1966 as a solution to provide health insurance coverage for those 65 and older.

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While the program covers several types of medical costs, it doesn’t include everything. Additionally, experts note, retirees are responsible for paying premiums and deductibles. This could result in retirees paying hundreds of dollars a month just to have the benefit.

“The premiums aren’t always zero dollars,” says John Barkett, senior director of policy affairs for Willis Towers Watson in Washington, D.C. “For example, you have to pay a Medicare Part B premium, which varies depending on your income, but for most people is about $140 a month.

“And that’s just when you become eligible for Medicare,” he adds.

Employers can step in to educate their employee base—and especially those nearing retirement—on the elements of Medicare coverage and what they will likely pay. Sources say providing education on the basics of Medicare terminology—such as Part A, B, C and D— and on additional savings benefits such as Medicare Advantage and Medicare Savings Programs (MSPs) can help participants map out their future health care costs.

“It really is important to start at the beginning,” notes James Jiang, the co-founder and CEO of Spark Advisors, a brokerage firm that partners with independent advisers to serve those navigating retirement benefits and Medicare. “Make sure that people have basic awareness of Medicare and all the various programs available.”

Experts recommend plan sponsors and their employees learn the ABCs of Medicare. According to eHealth Insurance, a private online marketplace for health insurance, Medicare Part A largely covers hospital expenses including inpatient hospital care, nursing facility care, hospice services and limited home health care. Medicare Part B, on the other hand, provides medical insurance and covers outpatient care, mental health services, lab tests, doctor visits, medical equipment and preventative services.

Aetna Medicare solutions provides a downloadable chart highlighting what Medicare Parts A and B (together, also known as Original Medicare) cover.

Medicare Advantage Plans, also known as Part C, are offered by private companies approved by Medicare. As Aetna’s research explains, these plans are serviced by private insurance companies and often include dental, vision or hearing services, prescription drug coverage and/or fitness club memberships. A Medicare Advantage plan offers at least the same benefits as Parts A and B.

Similar to Medicare Advantage, Part D is also offered through a network of private insurance companies approved by Medicare and is primarily used to fund a retiree’s prescription drug plan.

Medicare health care coverage is complex, and it’s even more convoluted for the average pre-or-current-retiree. In fact, it’s fairly common for an employee who is approaching age 65 to contact their employer and ask questions about Medicare, Barkett notes, adding that plan sponsors need to be prepared for that.

“Understand the rules and provide every source for employees to get more information on what they should be considering while they’re still working and when they are approaching Medicare age,” he says.

Jiang adds that plan sponsors should consider speaking with a financial adviser or providing a Medicare expert to host on-site or virtual meetings. Such experts can answer questions on when to claim Medicare benefits and whether enrolling into Medicare Advantage or a Supplemental Savings Plan is the right move for a particular employee.

“There is a huge advantage in bringing in a trusted adviser and someone who is really working for the employee,” he says. “There is an advantage to working with an adviser who is building a long-term relationship with the employee and is committed to doing basic education and ensuring these issues are top of mind for people as they enter Medicare eligibility.”

Longstanding Savings Gaps by Race, Ethnicity Persist

A new EBRI analysis of data taken from the Federal Reserve’s Survey of Consumer Finances underscores the persistently and perniciously unequal distribution of retirement savings in the United States.

The Employee Benefit Research Institute (EBRI) has published a fresh crop of data looking at the breakdown of retirement savings across the different racial and ethnic groups comprising the U.S. workforce.

EBRI says the data represents yet another clear piece of evidence that not every race/ethnic group is amassing similar levels of wealth within individual account retirement plans such as 401(k)s. It is derived from the Survey of Consumer Finances (SCF), which is the Federal Reserve’s triennial survey of wealth.

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According to EBRI’s analysis of the SCF data, just over half of families had an individual account-style retirement plan in 2019 (50.9%). However, the likelihood of having a retirement plan is significantly lower for families with Black/African American family heads than for families with white, non-Hispanic heads. Specifically, 57.2% of the latter and 34.9% of the former report owning some type of individual account savings plan.

EBRI reports the discrepancy is even greater for families with Hispanic heads. The data shows fewer than half as many (25.5%) families with Hispanic heads reported having retirement plan assets compared with families with white, non-Hispanic heads. EBRI also reports that these disparities have changed only marginally since 2010, showing the persistence of the issue.

EBRI finds families with Black/African American or Hispanic heads who did have a retirement plan also reported significantly lower median account balances than families with white, non-Hispanic heads. As of the end of 2019, EBRI reports, the median account balance of families with white heads was $80,000, versus $35,000 and $31,000 for families with Black/African American heads and Hispanic heads, respectively.

EBRI’s analysis concludes that families with minority heads are generally in a much worse position in their preparation for retirement in terms of individual retirement plan assets. As a result, EBRI says, these families are likely to have much less flexibility in financing retirement.

“Recognizing this, policymakers and employers appear to be placing a greater emphasis on addressing the inequities across races and ethnicities,” the analysis suggests. “Financial well-being programs can help address these disparities, particularly as employers develop holistic programs that address the full financial picture of employees and tailor these programs to the employees using them.”

EBRI’s analysis follows on the heels of a report published by the Investment Company Institute (ICI) showing total retirement plan assets grew to $34.9 trillion as of December 31, which is up 7.5% from the end of the third quarter of the year and up 9.3% overall for last year. With such strong growth for the year, the ICI reports, retirement assets accounted for a third of all household financial assets in the United States at the end of December.

The ICI update shows that assets in individual retirement accounts (IRAs) totaled $12.2 trillion at the end of the fourth quarter of 2020, while defined contribution (DC) plan assets were $9.6 trillion, up 6.8% from September 30.

Such growth figures would have been impressive in a “normal” year for the markets and the U.S. and global economies. But in the context of the ongoing coronavirus pandemic, which has now killed in excess of 525,000 Americans and caused historic surges in unemployment, the figures are even more notable. As various sources have discussed with PLANSPONSOR, the past year has made doubly clear the fact that the markets and the economy are not one and the same thing.

As demonstrated in the EBRI data, the past year (and decade) has also clearly demonstrated just how severe income and overall wealth inequality are in the United States. To be sure, since the global financial crisis of 2007 and 2008, U.S. households in the aggregate have come a long way in strengthening their balance sheets. Yet the distribution of wealth is highly unequal—about as unequal as it has ever been—and such research shows not everyone is able to participate in the growth of retirement plan assets.

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