Navigating Health Insurance & Medicare in Retirement: What Every Washington State Employee Needs to Know

Planning for retirement is an exciting milestone, but one of the most complex aspects is securing the right health insurance coverage. Many Washington State employees find healthcare costs and options confusing, especially when retiring before age 65 when Medicare eligibility begins.

In this guide, we’ll break down: ? The best health insurance options for Washington State employees. ? What happens if you retire before Medicare kicks in. ? How PEBB retiree health insurance works. ? The transition to Medicare at age 65 and how it integrates with PEBB. ? How to make the best healthcare choices for your retirement.

Understanding these key decisions now can help you avoid unnecessary stress and unexpected medical expenses later.

Health Insurance Before Age 65: What Are Your Options?

If you retire before 65, you must secure private health insurance or continue your coverage through an eligible employer-sponsored retiree plan.

Option 1: PEBB Retiree Coverage (Best for State Employees)

For many Washington State public employees, the Public Employees Benefits Board (PEBB) system provides a smooth transition from active employment coverage to retiree health insurance.

?? Who qualifies? Washington State public employees who retire under an eligible pension system. ?? What does it cover? Comprehensive medical, dental, and prescription drug benefits. ?? Is it affordable? Often more cost-effective than private insurance alternatives.

Why Choose PEBB Retiree Coverage?

Many retirees prefer PEBB coverage because it provides nationwide and international coverage. If you plan to travel or move after retirement, this can be a significant advantage over private health plans that have limited provider networks.

Additionally, PEBB plans often cover major medical expenses, including surgeries, hospitalizations, and prescription drugs with lower out-of-pocket costs compared to private alternatives.

?? PEBB is typically the best choice for Washington State employees retiring before Medicare eligibility.

?? For more details on eligibility and costs, visit the Washington State Health Care Authority.

Option 2: Washington Healthplanfinder (Best for Non-PEBB Retirees)

If you don’t qualify for PEBB retiree coverage, the Washington Healthplanfinder is a great resource to find private health insurance options before Medicare.

?? What is it? Washington’s official healthcare marketplace where retirees can compare private health plans. ?? Who should use it? Retirees who are not eligible for PEBB and need an affordable private health plan. ?? How does it work? You can compare plans, enroll online, and determine if you qualify for financial assistance.

?? To explore available plans, visit Washington Healthplanfinder.

Option 3: COBRA or Private Health Insurance Brokers

If you leave your job before 65, you may be able to continue your existing health insurance through COBRA for up to 18 months. However, COBRA can be expensive since you must pay the full premium cost without employer contributions.

Alternatively, some retirees prefer to work with a private health insurance broker to find the best available plans. This can be especially useful for those with specific medical needs that require customized coverage.

Medicare at 65: How to Transition & What You Need to Know

Once you reach age 65, you become eligible for Medicare, but there are several important decisions to make when enrolling.

Understanding Medicare Parts A, B, C, and D

Medicare is divided into four main parts:

? Medicare Part A (Hospital Insurance) – Covers hospital stays, nursing care, and hospice (typically free if you paid Medicare taxes). ? Medicare Part B (Medical Insurance) – Covers doctor visits, outpatient care, and preventive services (monthly premium required). ? Medicare Part C (Medicare Advantage) – A private insurance alternative that bundles Parts A and B and may include additional benefits like dental, vision, and hearing coverage. ? Medicare Part D (Prescription Drug Coverage) – Covers medications (separate plan needed if you have Original Medicare).

How PEBB Coverage Works with Medicare

If you are already on PEBB retiree coverage, your plan will change once Medicare becomes your primary insurance at age 65.

?? Medicare becomes your primary provider. ?? PEBB coverage acts as secondary insurance, covering costs Medicare does not. ?? Most PEBB plans function like Medicare Supplement (Medigap) or Medicare Advantage plans.

This means lower out-of-pocket costs and better coverage compared to standard Medicare-only plans.

?? To explore PEBB’s Medicare plans, visit the PEBB Medicare information page.

How to Choose the Best Health Insurance in Retirement

With so many options, it’s important to consider:

?? Your anticipated healthcare needs. Do you have existing conditions that require specialized care? ?? Your travel plans. Will you live in one state or travel frequently? ?? Your financial situation. Can you afford private health insurance, or do you qualify for PEBB or Medicare assistance?

?? Action Step: Start planning your retirement healthcare strategy at least 6-12 months before leaving your job.

Final Thoughts: Making the Right Choice for Your Retirement Health Insurance

?? If you qualify for PEBB retiree health insurance, it is likely your best option before and after Medicare enrollment at 65. ?? If you do not qualify for PEBB, you should explore Washington Healthplanfinder for private insurance options. ?? Once you turn 65, Medicare becomes your primary insurance, and PEBB (if applicable) provides secondary coverage.

Healthcare costs can be one of the biggest expenses in retirement, so choosing the right plan now can save you thousands of dollars and ensure access to the care you need.

?? Need help planning for your retirement?

?? Join our free retirement planning community for expert insights & exclusive tools. ?? Schedule a consultation for personalized retirement advice. ?? Get investment advice on TRS 3 & DCP Plans to maximize your retirement savings.

FAQs

1. Can I keep my PEBB retiree coverage after I turn 65?

Yes! Medicare will become your primary insurance, and PEBB will act as secondary coverage to reduce out-of-pocket costs.

2. What if I don’t qualify for PEBB?

If PEBB isn’t an option, Washington Healthplanfinder is the best way to find affordable private health insurance plans.

3. Do I need a Medicare Supplement plan if I have PEBB?

No, PEBB acts as a Medicare Supplement plan, covering costs that Medicare alone wouldn’t pay for.

4. How early should I start planning for Medicare?

You should begin the Medicare enrollment process 3-6 months before turning 65 to avoid any coverage gaps.

5. Does PEBB cover prescription drugs?

Yes! Most PEBB retiree plans include prescription drug coverage, making it one of the most comprehensive options available.