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How to Find Health Insurance for Dependents When Joining Medicare

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Enrolling in Medicare changes your health insurance, but it can also greatly impact your loved ones’ insurance. With no Medicare coverage available for dependents, anyone previously relying on your health plan will need to secure alternate coverage. At the age of retirement, your dependents may include a younger spouse or possibly a child under the age of 26.

Fortunately, there are a number of medical insurance options to consider. To avoid a lapse in coverage for your loved ones, your family needs to be prepared. The experts at Highmark Health recommend taking these steps to get the best possible insurance plan for your dependents:

Know when dependents should enroll in health insurance

Your dependents can enroll in an individual or family plan up to 60 days prior to losing your current commercial coverage. Before then, take time to explore the possibilities. “Give yourself enough time to research your options and gather information,” says Sandra Troia, director of telesales and channel operations at Highmark. “That way your family can make an informed decision.”

Once your loved one enrolls in a new plan, they should set the effective date to match the end date of the current coverage. If you lose coverage quickly and unexpectedly, new insurance for your dependent can be implemented the next day or be retroactive, but guidelines for those allowances vary by state and specific situation.

Identify the needs of your health insurance dependents

Before you do any research, take time to look at your dependent’s budget and needs for the new plan. “The big first step is to assess your dependent’s income,” says Mike Pelino, Highmark’s manager of segment strategy and analytics. If you are retiring, be sure to look at your dependent’s expected income after you retire, instead of your current combined income. “Budget defines what your loved one is comfortable paying in terms of a premium, or monthly payment.”

According to Pelino, your family income after retirement also determines whether or not your dependent will qualify for government premium subsidies, assistance, or programs. If your dependent is under 19 years of age, consider the Children’s Health Insurance Program (CHIP), a joint federal and state program. Your uninsured child may get health coverage through CHIP if your family’s income is too high to qualify for Medicaid and too low to afford private insurance.

Other details to consider for your dependent include the length of coverage and type of plan needed. A young adult needs insurance for years to come, while your spouse may only require coverage for a couple of years. “Sometimes a spouse’s employer offers an early retirement benefit plan, which is an easy solution,” Pelino says. “If not, there are other options. It’s all dependent on your family’s personal preference and situation.”

Understand COBRA health insurance

One insurance option that all dependents should consider is coverage through the Consolidated Omnibus Budget Reconciliation Act or COBRA. Through COBRA, most group health plans provide temporary continuation of coverage for spouses and dependent children after an employee retires. The maximum period of coverage is 36 months from the date that your Medicare begins.

Keep in mind that COBRA leaves your dependent responsible for the full cost of the coverage. But that expense may be worth it. “COBRA might be the better option for short-term insurance,” says Tiffinnie Severin, director of distribution and retention strategy at Highmark. “This is where research and preparation really pay off so you can compare the options.”

Research individual health insurance plans

For many dependents, an individual health plan makes the most sense. “There are many options and choices available, so your dependent can find the best plan in terms of cost and network,” Pelino says. But wading through the possibilities may be daunting.

To help your family navigate the best plans for your situation, Pelino recommends visiting Highmark.HealthSherpa.com  if you are in Delaware or West Virginia. This online tool identifies opportunities for your dependent to save and compares plans that are both available and appropriate. You can also enroll your dependents through this site. If you are in Pennsylvania, visit https://www.discoverhighmark.com/

Consult with a health insurance agent

No matter how much research you do, there are many benefits of using a licensed insurance agent . Agents bring expertise, identify possible government assistance, and offer convenient ways to connect. “There are many ways to work with a licensed insurance agent including over the phone or in person” Severin says. “It’s personal preference as to which option works best for your family.”

At Highmark, you can meet with an ACA individual and family plan advisor over the phone, or in person at a Highmark Direct Health Insurance Store  (for beneficiaries located in Pennsylvania). Before consulting with a health insurance agent, Severin recommends that your dependent gathers information, including:

  • Preferred providers
  • Current prescriptions
  • Financial information, including expected income and budget for health care

“The most important thing for your dependent to have is their budget,” Severin says. “Identifying a comfortable spending level narrows down the options. Then a professional can help your family choose the perfect plan.”


Highmark can help with all your insurance needs

To learn more about getting insurance for your dependents once you join Medicare, schedule a personal consultation   with a licensed Highmark insurance agent by calling 855-635-4566  (TTY/TDD users may call 711) Monday – Friday, 9 a.m. – 7 p.m. or Saturday from 9 a.m. to 2 p.m.