Retirement Health Insurance & Medicare: What You MUST Know as a Washington State Employee!

Retirement Health Insurance & Medicare: What You MUST Know as a Washington State Employee!

Planning for retirement is already overwhelming, but when you add health insurance and Medicare into the equation, it can feel even more complex. Many retirees struggle with finding affordable coverage before they become eligible for Medicare at age 65.

In this guide, we’ll break down the best health insurance options for Washington State employees, how Medicare integrates with PEBB retiree coverage, and key decisions you’ll need to make along the way.


Health Insurance Options Before Age 65

If you retire before 65, you’re not yet eligible for Medicare, meaning you must secure private health insurance or continue coverage through your employer’s retiree plans (if available).

PEBB Retiree Coverage: The Best Option for Most State Employees

If you worked for the State of Washington, a school district, or another public employer that participates in the Public Employees Benefits Board (PEBB) system, you may qualify for PEBB retiree coverage.

Key Benefits of PEBB Retiree Coverage:

?? Allows you to continue similar medical and dental benefits as when you were employed. ?? Often more affordable than private health insurance options. ?? Covers prescription drugs, medical visits, and hospital stays. ?? Provides nationwide and international coverage—great for retirees who travel.

Most of the time, PEBB retiree coverage is the best choice for Washington State employees retiring before age 65. The plans often offer better coverage at a lower cost than what you’d find in the private market.

How Much Does PEBB Retiree Coverage Cost?

While PEBB retiree health plans can be more expensive than employer-sponsored plans, they are often cheaper than private insurance options. The exact cost depends on the plan you choose, your dependents, and other factors.

To view the latest PEBB retiree health insurance rates, visit the Washington State Health Care Authority website.

What If I’m Not Eligible for PEBB Retiree Coverage?

If you worked for a city, county, or another public employer that does not participate in PEBB, you will need to find your own health insurance. Fortunately, Washington State has resources to help.


Washington Healthplanfinder: Best Marketplace for Private Insurance

If PEBB is not an option, your next best choice is shopping for health insurance through Washington Healthplanfinder, the state's official health insurance marketplace.

How to Use Washington Healthplanfinder

? Visit Washington Healthplanfinder.

? Enter your income and household information to see available plans.

? Compare monthly premiums, deductibles, and out-of-pocket costs.

? Enroll in a plan that best fits your needs.

Some retirees may qualify for subsidies or tax credits depending on their income level. If you expect your income to be lower after retirement, you might be eligible for premium reductions to lower your healthcare costs.

Other Private Insurance Options

If you don’t want to use Washington Healthplanfinder, you can also:

?? Buy a private health plan through a licensed insurance broker.

?? Continue coverage through COBRA, though this is often expensive.

?? Join a spouse’s health insurance plan, if applicable.


Transitioning to Medicare at Age 65

Once you turn 65, you qualify for Medicare, the federal health insurance program for seniors. However, Medicare doesn’t cover everything, so many retirees choose additional coverage to help with out-of-pocket expenses.

How Medicare Works

Medicare is divided into four parts, each covering different types of healthcare expenses:

  • Part A: Covers hospital stays, skilled nursing care, and hospice care (usually free).
  • Part B: Covers doctor visits, outpatient care, and preventive services (monthly premium applies).
  • Part C (Medicare Advantage): A private insurance alternative that bundles Parts A and B, plus additional benefits.
  • Part D: Covers prescription drugs.


How PEBB Retiree Coverage Works With Medicare

If you are already enrolled in PEBB retiree coverage before turning 65, your plan will change once Medicare becomes your primary insurance.

PEBB and Medicare: How They Coordinate

  • Medicare (Parts A & B) becomes your primary provider.
  • PEBB coverage acts as your secondary provider, covering remaining costs.
  • Many PEBB plans function like a Medicare Advantage or Medigap plan.
  • Prescription drug coverage is included in most PEBB retiree plans.

PEBB retirees generally enroll in Medicare Part A and Part B, then choose a PEBB plan that works best with their Medicare coverage.

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


Final Thoughts: Choosing the Best Health Insurance in Retirement

Whether you retire before or after 65, selecting the right health insurance plan is a critical step in retirement planning. Here’s a quick recap:

?? If you are eligible for PEBB retiree coverage, it is likely your best option before and after 65.

?? If you are not eligible for PEBB, check Washington Healthplanfinder for private health insurance plans.

?? Once you turn 65, Medicare becomes your primary insurance, and PEBB acts as secondary coverage.

Making these decisions can be stressful, but taking the time to understand your options will help you choose the best plan for your needs and budget.


FAQs

1. What if I retire before age 65 and don’t qualify for PEBB?

You can shop for private health insurance through Washington Healthplanfinder or purchase a plan through a private broker.

2. How much does PEBB retiree coverage cost?

PEBB plans vary based on the coverage level and selected options. To see current rates, visit the PEBB retiree insurance rates page.

3. Do I have to enroll in Medicare if I already have PEBB coverage?

Yes, once you turn 65, Medicare becomes your primary insurance. PEBB retiree coverage will act as secondary insurance.


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