Retirement on the horizon? 5 questions you should ask about health insurance

Waking up on your own time clock. Hitting the gym after rush hour has passed. Meeting friends for lunch. If you're getting close to retirement, the good stuff is easy to understand. More complex: figuring out health insurance. Here's what to think about first.

1. When should I start exploring my options?

You can enroll in Medicare three months before your 65th birthday month, but give yourself time to learn what the program offers, says Rebecca Kinney, acting director of the Office of Healthcare Information and Counseling for the Administration for Community Living with the U.S. Department of Health & Human Services. Her advice: Dive in six months before your 65th birthday. You'll have a seven-month window to sign up, "but prices change, so it doesn't help to make your decision too early," Kinney says.

In addition, if you're already eligible for Medicaid, which offers low-income medical assistance, you may be eligible for Medicare (about 20 percent of the former qualify for the latter). However, rules vary by state so it's best to check the limitations where you live.

2. How does Medicare work?

Big picture — you'll decide between the following:

Original Medicare plans include Hospital (Part A) and Medical (Part B) insurance. You can also sign up for drug coverage (Part D). Original Medicare plans cover any doctor or hospital, but you'll usually pay out of pocket until you reach a deductible. Thereafter, you'll pay 20 percent of the approved amount (aka co-insurance). There's no limit on what you pay out of pocket every year.

Medicare Advantage plans work like health maintenance organizations, with approved provider networks; drug coverage is usually included. Once you reach the annual limit on out-of-pocket expenses for covered services, you'll pay nothing for them for the rest of the year.

3. What about costs that aren't covered?

If you sign up for Original Medicare and you or your partner are still working, you can supplement its coverage with work insurance. Either way, you have the option of adding private Medicare Supplement Insurance, also known as Medigap. The government has licensed some private carriers to sell Medigap, which helps cover co-payments, deductibles and co-insurance expenses under Original Medicare.

4. Who can help me sort through all this?

Federally funded State Health Insurance Assistance Programs (often known as SHIPs) offer certified, unbiased counselors to help you explore Medicare options. Their services are free, and they have offices nationwide.

Plan on at least two meetings to get up to speed, says Kinney — maybe a group overview first and a one-on-one session a month later, when a counselor can help you sign up. To locate the office nearest you, call 877-839-2675 or go to shiptacenter.org and click on "Find Local Medicare Help."

5. What if I'm planning to retire early or work past 65 ?

You can't sign up for Medicare early, but if you leave your job before turning 65, you can stay on a company plan for 18 or 36 months through COBRA (the Consolidated Omnibus Budget Reconciliation Act). Be sure to compare options through the Affordable Care Act and your insurance agent.

If you plan to keep working after 65, Kinney warns, you should still sign up for Medicare if you're self-employed. "I've worked with people who assumed that if they weren't collecting Social Security yet, they also could wait to sign up for Medicare," she says. "So they kept paying privately for their health insurance and didn't sign up."

The result: a hefty penalty. "As soon as you're eligible, you've got to enroll unless you're part of an employer plan," she says.

Senior citizen health insurance with pre-existing conditions

Senior citizen health insurance with pre-existing conditions is designed to provide medical coverage for older adults who have pre-existing medical conditions. If you're a senior with a pre-existing condition, it's important to have health insurance that covers your healthcare needs and helps manage the costs of treatment.

Here are some things to keep in mind when shopping for senior citizen health insurance with pre-existing conditions:

• Coverage: Make sure that the insurance policy provides coverage for the services you need to manage your pre-existing condition, such as doctor visits, prescription medications, and hospitalization. Some policies may also cover rehabilitation services and medical equipment.
• Cost: Check the premiums, deductibles, copays, and coinsurance for the policy to ensure that they are affordable and fit within your budget.
• Waiting Period: Some insurance policies have a waiting period before coverage takes effect for pre-existing conditions. Make sure that you're aware of any waiting periods and plan accordingly.
• Network of Providers: Check to see if the policy has a network of providers that you can access in your area. This can help to ensure that you receive quality care and can help to reduce out-of-pocket costs.
• Additional Benefits: Some senior citizen health insurance policies may offer additional benefits, such as wellness programs, preventive care services, and coverage for dependents.
• Customer Service: Look for a policy with good customer service, including a 24/7 helpline and assistance with navigating the healthcare system.

When shopping for senior citizen health insurance with pre-existing conditions, it's important to compare policies from multiple insurance providers to find the coverage and rates that best meet your needs. It's also important to be honest about your pre-existing conditions when applying for coverage, as failure to disclose pre-existing conditions could result in denial of coverage or cancellation of the policy.

Short-term health insurance for travelers

Short-term health insurance for travelers is designed to provide medical coverage for individuals who are traveling for a short period of time. This type of insurance typically offers temporary coverage for medical emergencies or unexpected illnesses while you're away from home.

Here are some things to keep in mind when shopping for short-term health insurance for travelers:

1. Coverage: Make sure that the insurance policy provides coverage for the services you need, such as doctor visits, hospitalization, emergency medical evacuation, and prescription medications. Some policies may also provide coverage for dental and vision services.
2. Length of Coverage: Short-term health insurance policies typically provide coverage for a period of 30 days to 364 days. Make sure that the length of coverage matches the length of your trip.
3. Geographic Coverage: Make sure that the insurance policy provides coverage in the countries where you'll be traveling. Some policies may have exclusions or limitations on coverage for certain countries or regions.
4. Deductible and Copayments: Check the deductible and copayments for the policy to ensure that they are affordable and fit within your budget.
5. Pre-existing Conditions: Short-term health insurance policies may not cover pre-existing medical conditions. If you have a pre-existing condition, make sure that the policy provides coverage for it, or consider purchasing a policy that includes a pre-existing condition waiver.
6. Customer Service: Look for a policy with good customer service, including a 24/7 helpline and assistance with navigating the healthcare system in your host country.

When shopping for short-term health insurance for travelers, it's important to compare policies from multiple insurance providers to find the coverage and rates that best meet your needs. It's also important to read the policy carefully to ensure that you understand the coverage and any limitations or exclusions that may apply.

Group health insurance for small businesses

Group health insurance for small businesses is designed to provide medical coverage for employees of a small business. These types of policies allow employers to provide health benefits to their employees at a more affordable cost compared to individual health insurance plans.

Here are some things to keep in mind when shopping for group health insurance for small businesses:

• Coverage: Make sure that the insurance policy provides coverage for the services your employees need, such as doctor visits, hospitalization, prescription medications, and emergency services. Some policies may also provide coverage for mental health services, wellness programs, and preventive care.
• Cost: Check the premiums, deductibles, copays, and coinsurance for the policy to ensure that they are affordable and fit within your budget. Keep in mind that some policies may require employers to contribute a certain percentage towards the premiums.
• Network of Providers: Check to see if the policy has a network of providers that your employees can access in their area. This can help to ensure that they receive quality care and can help to reduce out-of-pocket costs.
• Employee Eligibility: Make sure that you understand the eligibility requirements for employees to enroll in the policy, such as minimum hours worked per week or waiting periods.
• Additional Benefits: Some group health insurance policies may offer additional benefits, such as dental and vision coverage, wellness programs, and coverage for dependents.
• Customer Service: Look for a policy with good customer service, including a 24/7 helpline and assistance with navigating the healthcare system.

When shopping for group health insurance for small businesses, it's important to compare policies from multiple insurance providers to find the coverage and rates that best meet your needs as an employer. It's also important to communicate the details of the policy clearly to your employees and provide resources to help them understand their coverage and how to use it.