Archived Insight | February 18, 2021

Retiree Medical Coverage: Are You Getting the Best Value?

While many organizations have moved away from offering retiree medical benefits to avoid the future financial obligations of such programs, some employers still offer them as a key component of their employee value proposition.

This is particularly important as we see Americans living longer and potentially lacking means to afford necessary healthcare in their later years.

retiree medical coverage

Why retiree medical?

By continuing to offer retiree medical benefits, organizations can reap important benefits:

  • Avoid the costs of retirement delays: One study showed that employers pay an additional $10,000 to $50,000 in costs for every year an employee delays retirement because they can’t afford it.
  • Dramatically reduce the medical costs for Medicare-eligible employees through timely retirement
  • Improve retention of future stars by encouraging talent succession
  • Improve retirement readiness and awareness
  • Offer more robust key employee compensation packages

Balancing benefits, costs and risk

While the advantages of a well-designed retiree medical program are clear for most participants, employers need to balance this benefit with the costs and risks of the coverage. Best practices suggest that employers ask themselves the following questions:

  • Have we looked into the savings offered from the private Medicare exchange market and/or Medicare Advantage programs?
  • Are we maximizing the Rx government subsidies for our Medicare retiree population?
  • How long has it been since the program was updated to reflect retiree population health trends?
  • Is the program compliant with appropriate legal obligations, such as HIPAA privacy and security standards?

Optimizing your retiree medical offering

You can optimize your retiree medical offering by looking at the 3 Rs of cost containment:

  1. Redefining eligibility requirements: Tie eligibility to service levels, consider institutional goals for workforce planning and review spouse coverage rules
  2. Restructuring benefits: Create tier for new hires, reduce benefits for future retirees and eliminate Rx benefits for Medicare-eligible participants
  3. Rethinking cost sharing: Move to a flat dollar employer share, fund while employees are active via defined contribution plans, and leverage Medicare private exchanges

Questions about retiree medical coverage?

We're here to help. Get in touch. 

See more insights

Crowd Of People On The White House Grounds

How the One Big Beautiful Bill Act Will Impact Health Plans

Segal's July 30 webinar explores how the Big Beautiful Bill Act and recent SCOTUS rulings may reshape health plans and compliance strategies.
Doctor With Psoriasis Patient

Q3 2025 Trends Focus: Specialty Dermatological Drugs

Learn about the rising cost of these drugs, emerging therapies for psoriasis, the biosimilar market and four cost-management strategies.
Doctor Explaining The Diagnosis To A Girl And Her Father In The Consultation Room

Budget Act Provisions that Affect Employee Benefits

Plan sponsors: Review several parts of the bill, particularly those related to Health Savings Accounts (HSAs) and certain other fringe benefits.

This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.