Retirement Scenarios

Scenario 1: Professor Planning Standard Retirement at 65

Professor Garcia is turning 65 in September and plans to retire from full-time teaching at the end of the fall semester (December) and is enrolled in a Rice medical plan.

Medicare Approach Key Considerations
  • Should begin researching Medicare options by October (3 months before retirement)
  • No need to enroll in Medicare Parts A and B during the Initial Enrollment Period (June-December), as Rice's medical plan is primary coverage. She may enroll in Medicare Part A, which is no cost, at age 65 as long as she is not enrolled in Rice's HSA plan (associated with our consumer-driven medical plan)
  • Request CMS-L564 form from HR in late September to document university coverage through December 31
  • Enroll in Medicare Part A and B on or after October 1, with an effective date of January; provide completed CMS-L564 Social Security office or online
  • If considered a Rice Retiree (per Policy 414), contact Via Benefits for guidance and assistance with enrolling in supplemental coverage (Medicare Advantage or Medigap/Part D)
  • Compare Medicare Advantage or Medigap/Part D plans after enrolling in Medicare Part A & B to have coverage ready for January
  • Timing retirement at the end of the semester minimizes disruption to students
  • University health coverage ends December 31, so Medicare and supplemental plans should start January 1
Scenario 2: Faculty Member Working Past 65

Professor Johnson turned 65 last year but plans to continue teaching full-time for another 3 years and is enrolled in a Rice medical plan.

Medicare Approach Key Considerations
  • May delay Medicare enrollment without penalty due to active employer coverage
  • May enroll in premium-free Part A at 65 (unless contributing to the HSA plan associated with Rice's consumer-driven plan)
  • Delay Part B enrollment until retirement to avoid paying premiums while still covered under Rice's medical plan
  • When ready to retire, will use Special Enrollment Period with CMS-L564 form from HR
  • Has 8 months after retirement to enroll in Medicare without penalty, but do not delay; you are encouraged to time the enrollment with your retirement from Rice
  • If participating in research or sabbatical abroad, should verify international coverage options with the supplemental plans
  • May want to attend Medicare information sessions offered by Rice 1-2 years before planned retirement
Scenario 3: Early Retirement at 63

Dr. Williams is taking early retirement at age 63 due to health concerns and is enrolled in Rice's medical coverage prior to retirement.

Medicare Approach Key Considerations
  • Not eligible for Medicare until age 65
  • Needs to secure alternative health insurance for the gap period (age 63~65)
  • Options include:
    • Rice's pre-65 Retiree Medical plans are available to all Rice Retirees and their enrolled dependents, per Policy 414. Please refer to this website for more details.
    • COBRA coverage from Rice (typically up to 18 months)
    • Coverage through spouse's employer plan, if available.
    • Individual marketplace plan (healthcare.gov)
  • Should begine Medicare enrollment process no earlier than 3 months before the month in which they turn 65
  • Budget for potentially higher insurance premiums during the gap period
  • Calendar reminder to apply for Medicare at 65 to avoid late penalties
  • Investigate if any health condition qualifies for Social Security Disability, which could provide earlier Medicare eligibility (typically limited to End Stage Renal Disease or Amyotrophic Lateral Sclerosis)
Scenario 4: Faculty Member with Dependent Spouse

Professor Taylor is retiring at 66, but her spouse is 62 and has been covered under the university's family health plan.

Medicare Approach Key Considerations
  • Enroll herselt in Medicare Part A & B upon retirement
  • Select appropriate supplemental coverage based on health needs
  • Options for spouse:
    • Rice's pre-65 Retiree Medical plans are available to all Rice Retirees and their enrolled dependents, per Policy 414. Please refer to this website for more details.
    • COBRA coverage from Rice (typically up to 18 months)
    • Coverage through spouse's Medicare plan is NOT an option as Medicare doesn't offer family coverage. Everyone in Medicare is an individual.
    • Individual marketplace plan (healthcare.gov)
    • If spouse has own employer coverage, s/he can enroll during qualifying life event.
  • If participating in research or sabbatical abroad, should verify international coverage options with the supplemental plans
  • May want to attend Medicare information sessions offered by Rice 1-2 years before planned retirement
Scenario 5: Faculty Member Managing Chronic Health Conditions

Dr. Rivera is 65 with diabetes and heart disease, planning to retire next year after 30 years of service; enrolled in Rice's medical plans.

Medicare Approach Key Considerations
  • Thorough assessment of all current medications, treatments, and providers
  • Detailed comparison of Option 1: Original Medicare + Medigap + Part D vs. Option 2: Medicare Advantage
  • If choosing Option 1:
    • Select a Medigap plan with strong coverage for ongoing care needs
    • Select Part D plan that includes all current medications in favorable tiers
  • If choosing Option 2:
    • Verify all specialists are in-network
    • Check the plan's Start Rating for chronic condition management
    • Review prior authorization requirements for special treatments
  • Continuity of care with existing specialists is often critical
  • May need to calculate annual out-of-pocket costs based on predictable healthcare usage
  • Consider plans with additional benefits for chronic condition management
  • Review prescription formularies carefully, including quantity limits and step therapy requirements
  • May benefit from Medicare's Special Needs Plans (SNPs) if eligible
  • Budget for potential healthcare inflation for long-term condition management

Questions? Please contact Kayla Randolph, PhD (Sr HR Consultant)