As an HR pro, you’re probably already intimately familiar with all of the healthcare options your organization offers. (Let’s face it…maybe you even know a little too much.)

When our job is to make our workplaces as comfortable as possible for all employees, we make it our responsibility to study up on our benefits packages so that we can offer the best information to our team members. But recently, our team here at Jellyvision has realized that there might just be a gap in most HR pros’ knowledge when it comes to healthcare—and that’s Medicare. 

Employers don’t tend to focus much on Medicare when it comes to benefits education. After all, it’s traditionally been a service that retired Americans use. By the time they enroll, they’re not employees at your company anymore.

But today, older employees are putting off retirement and staying at work longer. That means there’s a growing need for HR teams to improve their knowledge of the Medicare system, so that they can properly inform their aging workforce when the time comes.

Understanding Medicare’s ins and outs can be a daunting task, but we have you covered. In this guide, we’re sharing information you need to know about Medicare to help your employees make more informed decisions.

A Look at the Current State of Medicare: An Explainer for HR Teams

What exactly is Medicare, and who’s eligible for it?

Not only can Medicare be confusing in general, but coverage and costs can also change every year. So we’re breaking down the basics for you, along with the most current government-provided guidelines. 

From a general overview of the different types of coverage to recent trends, here’s a look at the current state of Medicare.

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What Does Medicare Cover? A Guide for HR Teams to Share With Employees

When employees invest in health insurance, they want to know that their specific needs will be covered. And as an HR pro, it’s your job to help them answer questions about which medical procedures, services, and prescriptions are covered under Medicare. 

So we’ve put together a guide of what’s covered (and not covered) under the Medicare umbrella, helping to answer questions like: 

  • What does Medicare consider “medically necessary?”
  • What does Medicare consider “preventive services?”
  • Does Medicare cover dental care? Eye exams? Hearing aids? Chiropractic services?

Learn more about what Medicare covers here.

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How HR Teams Can Help Employees Apply for Medicare

If you have employees nearing retirement age, they’ll probably have questions about when and how to apply for Medicare. And while they’re still your employees, it’s your job as HR pros to help them feel informed when it comes to choosing and enrolling in the plans. 

So arm yourself with answers to their most pressing questions, like: 

  • Who qualifies for Medicare?
  • Where do I apply for Medicare? 
  • When should I apply for Medicare? 
  • When does coverage start? 
  • How does Medicare work with employer health plans?

Here’s a detailed overview of how to help your employees apply for Medicare.

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Comparing Medicare and Medicaid: How to Explain the Difference to Your Employees

Medicare and Medicaid: they sound the same, right? They only differ by two letters! Both are government programs. Both are administered by the Centers for Medicare & Medicaid Services (CMS). And both help people pay for health care. So, it’s not surprising that people have a hard time telling them apart.

But that’s about where the similarities end. They’re actually completely different programs, that serve unique populations and offer their own healthcare services.

So, what is the difference between Medicare and Medicaid? Let’s take a closer look, so that you can explain it to your employees.

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How Much Does Medicare Cost? Helping Employees Break It Down

Almost 1 in 5 Americans are covered by Medicare. But the average understanding of how it works, how to use it, and how to pay for it is…underwhelming at best.

That means your aging workforce is likely confused about how much they’ll owe on healthcare this year—all while inflation soars, the cost of living rises, and wages are stagnant. Not exactly ideal, huh? 

Let’s explore how much Medicare costs, part by part, and how to help employees understand their payment options. (Lots of numbers ahead—don’t get too cross-eyed!)

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Aging and Medicare: The Top 10 Questions Employees Ask Their HR Teams

By 2035, 16% of the workforce will be 70 or older. That’s about 1 in 6 employees! Talk about a seismic shift. 

And as folks age, their medical needs change, too. They’re more likely to need new services like home health care, skilled nursing, and physical and occupational therapy. And as they think about transitioning from their employer-sponsored health plan to Medicare, they’ll want to know that these new medical needs are covered. 

So let’s take a look at some of the most common questions employees have about Medicare when it comes to aging specifically, like: 

  • Does Medicare pay for assisted living?
  • Does Medicare cover nursing homes? 
  • Does Medicare cover home health care?
  • Does Medicare cover hospice? 

Get the full list of questions and answers about aging and Medicare here. 

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Medicare and Taxes: Everything Your Employees Should Know

You know what they say—the only certainties in life are death and taxes. But when it comes to actually understanding taxes and how they impact healthcare spending? Things get…well, a lot less certain. 

Healthcare expenses are a significant burden for our employees, especially as they get older and need more medical attention. And Medicare is a valuable resource for aging employees as they look for ways to save. But how do taxes play a role in funding this government-sponsored healthcare option? 

Let’s explore what your employees need to know about Medicare and taxes, including how Medicare is funded, who pays for it, and how employees can plan for Medicare-related expenses as they approach retirement.

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What is the “Donut Hole” in Medicare?

No, it’s not a treat you can pick up from Dunkin’. 🍩 (We wish.) 

The “donut hole,” also known as the coverage gap, is a temporary limit on how much Medicare will pay in prescription drug coverage under Part D

The donut hole happens when a Medicare user has reached their initial coverage limit but before they have spent enough on their prescriptions to reach what’s called a “catastrophic coverage threshold.”

We know…one more complication in the ever-confusing world of Medicare. Here’s a more detailed rundown of what the donut hole in Medicare is, and how you can explain it to your employees. 

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There’s a better way to navigate the Medicare maze

As the workforce continues to age, Medicare will become increasingly important for many of your employees. As an HR professional, it’s vital to stay up-to-date on changes to the program and communicate these updates to your staff regularly. By doing so, you can help your employees navigate the complexities of Medicare, ensuring they have access to the best healthcare options available.

But we know you’re also short on time, so becoming a Medicare expert might not be at the top of your to-do list. That’s where Jellyvision can help.  

ALEX Medicare asks important health questions to help employees navigate their Medicare options. Available via ALEX Benefits Counselor or ALEX Go, Medicare-eligible employees can access information wherever they are, on whatever device they’re most comfortable using. 

Find out how ALEX can help employees navigate the Medicare maze. 

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