A continuation of the Roger Strader Case
Roger Strader works for a small manufacturing company and is married to Amy, who were high school sweethearts and are both currently 64 years old. He receives an annual salary of $80,000 and Amy works as an administrative assistant at a law firm and makes $30,000 annually. Amy has medical coverage through her employer and Roger's company purchased health insurance for each of their employees. The plan is a PPO with a $2,000 deductible, 80% co-insurance, $25 office copays, pharmacy benefits and a maximum out of pocket limit of $7,000. It is an ACA plan and provides free preventive health services that Roger routinely utilizes.
One day as Roger was cutting a tree limb from a tree in his yard, he slipped and the chain saw fell on his leg. Roger was rushed to the local hospital where he underwent surgery, and then spent 15 days in the hospital. The ride in the ambulance cost $1,000. Surgery and anesthesia were $45,000; hospital room and board cost $800 per day. Drugs and rehabilitative care came to $15,000.
- Roger and Amy both have been paying Social Security taxes during their entire work life. Bothy have accumulated over 40 credits under the program. What is Roger's insured status under the Social Security program.
- Roger is considering early retirement due to the continued challenges with his leg due to the accident. Is he eligible to receive social security benefits at his current age? If so, how would his benefits be impacted if he were to begin to receive them today?
- If Roger waits until his full retirement age, would his benefits begin automatically? Explain.
- Assume that Amy continues to work until she is 65 and plans on working for several more years. She believes she can get better coverage at a lower cost under Medicare than her employer provided medical plan. Describe what benefits she would receive from Part A and Part B of Medicare.
- How would Medicare Advantage increase her benefit options?