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Preretirement Checklist

 

This document is intended to provide an overview of various considerations associated with retirement. There is significant complexity to much of this process, having to do in part with differences in local contracts, organizational rules, personal circumstances, and federal guidelines among other things. Therefore this overview will necessarily deal in generalities and might be only one part of your retirement planning process. Also, retirement is a good time for recording personal information important to a person’s family on one’s death. You may find this  
Personal Information Template useful for recording such information. It is also included on the AAP Senior Section Web site in the Living Well subsection of “Health & Wellness”.

This file is prepared, and frequently updated, by Michael O’Halloran MD FAAP


I. Insurance and Retirement Funds
Department of Human Resources (Employer): If you are working where there is such a department, it will likely be of considerable help with retirement plans and should be contacted.

Health Insurance: After retirement, clinics and organizations will sometimes continue to help pay for this, subject to certain rules. For example, premiums might be paid for you and possibly your spouse until death, depending on years of service and age at retirement. If you retire prior to eligibility for Medicare, ask about COBRA insurance from your employer. Also you might check with your state because some states have laws which complement the federal COBRA laws.

Dental insurance: Same. If your coverage ends, you might consider the Cobra option depending upon your circumstances.

Life Insurance: A conversion option may be available.

Long Term Disability Insurance: Typically can be safely discontinued if you are no longer working. Otherwise, check about the possible availability of a conversion option. And again, check with your state because some states have laws which complement the federal COBRA laws.

Retirement Plans, IRAs, Etcetera: You will likely need to contact your “Pension Carrier” (and maybe your personal financial consultant) regarding this. Your plan may have special rules you’ll need to comply with. Also, several distribution options are usually available. Keep in mind the requirement to make obligatory “minimum” withdrawals from age 701/2, referred to as Required Minimal Distributions (RDMs).

These areas of legal and financial planning may require consultation with specialists in either “elder law” or estate planning. To learn more about “elder law” view the information at public interest elder law groups such as the Connecticut Legal Services Elder Law Project or the Elder Law Center of the Coalition of Wisconsin Aging Groups or resources of the AARP.

Health Care Spending Account: If you have such an account you should learn whether there are special retirement rules depending upon such things as your organization’s fiscal year, your actual date of retirement, etc.

Social Security: If you are old enough to receive benefits you’ll need to check with your social security office. Contact them at least 90 days prior to retirement to discuss the initiation of benefits. Consider making arrangements for direct electronic deposits of your social Security payments to your bank.

Medicare: Timely application is essential. Delays in applying, if age eligible, can result in delays in benefits and higher premiums. The "initial enrollment period" for Medicare consists of the three months before, the month of, and the three months after your 65th birthday. If you want your coverage to start the month you turn 65, sign up during that first three-month period. Take the time to understand the parts of Medicare; Part A for hospital inpatient care, Part B for doctor services, Part C, Medicare Advantage, Part D, for prescription drugs.

Malpractice Insurance: There are two issues that must be addressed. They are arranging for “tail coverage” should a claim be brought against you after retirement and getting professional liability coverage in the event that you choose to perform part-time or volunteer medical work. Your malpractice insurance is most likely a Claims Made policy, the type that covers for events that take place and are reported while the policy is still in force. For coverage of events occurring during the time the policy is still in force but not reported until after that, you must purchase “tail coverage”. If you have the less common Occurrence policy you needn’t worry about the “tail”. In any event, check directly with your current malpractice insurer to assess your specific needs. When you check, also note the financial stability of your current malpractice insurer and inquire about arrangement for claims payment in the event of bankruptcy. Your State Department of Insurance or State Medical Society may also help in this area. Many arrangements may be available to you depending upon your circumstances. As to the need for professional liability insurance for volunteer work, this link to the professional liability coverage for volunteers explains several of the options.


II. Organizational Issues:
  • For those who are part of, or employed by, a medical organization there are often several steps to take for a smooth retirement (in addition to contacting your Human Resources Department, for the matters mentioned above).
    1. Contact your Department Chair, Department Supervisor and Medical Director. This is especially important when your retirement will require recruiting a replacement or changes in support staff. In some organizations the actual retirement date is only established after considering the needs of the department, those of the organization, and those of the retiree.
    2. An exit interview with the leadership of your group may be an option.
    3. Attend to mailing address, phone number and email address changes.
    4. There may be ways to maintain some contact with your colleagues, clinics, or hospitals after retirement. Making contact with someone who has already retired will usually be helpful.
    5. If your group has an Information Systems department, you may need to contact the department director.
    6. Notify your Mail Room
    7. Contact your financial services payroll person.
    8. Learn whether there are special arrangements for vacation benefits during the retirement year.

  • For all practices, not just larger medical organizations.
    1. Attend to preservation or destruction (and patient notification about) medical records. Here is a helpful link from the AMA​. State statutes about this vary so getting proper advice is important. [For example, Wisconsin requires one of several combinations of actions.]
    2. For those in partnerships or for some incorporated practices there may be a buy-out requirement with the other partners or shareholders. Consultation with the interested parties about your particular buy-out agreement is essential.
    3. Determine whether there are any continuing privileges such as access to doctors parking at the hospital or clinic, email privileges, or access to a fax machine.
    4. Contact Medical Staff Secretary of hospitals with which you are affiliated.


III. Personal Issues
In addition to the above issues you may want to consider taking care of some of these more personal matters.

  1. Physical exam
  2. Seek financial and estate planning advice (Money Manager, Financial Planner, Accountant, Lawyer, etc.). A financial advisor can also help you learn about special opportunities available to you. Estate planning seminars are also available but, while some are excellent, others turn out to be sales pitches so be careful.
  3. Review how your assets are held (e.g., Joint tenancy, Tenancy in common, etc.), and review beneficiary designations (IRAs, Insurance, Transfer on Death, Trusts, etc.)
  4. Review and update your Will, Durable Powers of Attorney, and Estate plans. General attorneys do this of course, but there are also those who specialize in estate law and elderlaw.
  5. Be sure you have reviewed your Living Will/Health Care Proxies/Advance Health Directives and consider giving a copy to your primary care physician, designated family members, and local hospital medical records. Consider a copy for the car. Consider having a note in your wallet about the whereabouts of your advance directive.
  6. If you wish to be an organ donor, now would be a good time to consider getting your name on your state’s Organ Donor Registry, and talking to your family about it.
  7. Notify your academic and professional groups about your retirement and decide whether to volunteer to help, to continue under a retiree status, or cancel.
  8. The American Academy of Pediatrics offers a reduced membership fee for those who qualify as a Senior Member. You qualify if you are a member in good standing and at least 70 years old, or 65 years old and no longer deriving income from professional employment.
  9. Remain active in the AAP with the AAP Senior Section. See the variety of contributions that you can continue to make to the welfare of children and ways the AAP can continue to serve you at http://www.aap.org/seniors. The Section’s mission is to “provide opportunities for our members to remain involved with the AAP in a meaningful way, to foster the growth and development of younger members through effective mentorship, and to provide experience and resources that will support our members as “they make transitions in their personal and professional lives”.
  10. Depending upon your age, you may want get information about Social Security and Medicare. Many issues can come up relating to your situation and application needs to be made several months ahead.
  11. Web site help: There are many of these. The AMA has a new web page for their new Senior Group with several suggestions. Other examples include www.nolo.com for estate planning, and www.medicare.gov for Medicare. AARP also maintains a good website. The NOLO website, Helping Survivors Manage Money and Finances has descriptions and links to help with the practical tasks after a death. Don’t forget the AAP Section for Senior Members website! Check out the Living Well and Health and Fitness Sections to aid in planning your retirement.
  12. Consider volunteering your medical expertise and/or child advocacy skills. Licensing and liability issues for volunteer work are different for each state. Check with your AAP Chapter and/or your State Department of Health. Find information about volunteering on the Opportunities page of the AAP Section for Senior Members website.
  13. Check out other opportunities depending upon your inclination, possibly including: hospital committees, state specialty organizations, local free clinic boards, health related boards such as United Cerebral Palsy, local arts boards, hospital advisory committees, assisting in research projects, political activities, university courses, courses from retirement organizations, etc., etc.
  14. Know that reentry into some form of clinical practice may suit you now or later. The AAP has sponsored an excellent workforce reentry project. See: http://physician-reentry.org/

    Keep in mind that a requirement for the category of Senior Member of the AAP is that one has no direct patient contact (unless you are over 70).
  15. Compose or update a document or letter to help your heirs and personal representative upon your death. Such documents include, but are not limited to, vital personal information such as Social Security, bank, trusts, location of assets, funeral preferences, and important documents. It may also include an inventory and/or description of where everything is kept, bank safe deposit box, or where in our home things are located. A Personal Information Template for recording such information is located here. Be certain that your heirs receive these documents in sufficient time to discuss them with you to understand your specific wishes after death or in the event one or both are not competent, or in the event that one or both of you are in a state such that care should be withdrawn except for relief of discomfort. Note – this may be in addition to your will but can provide your heirs with information about immediate action steps that may be required and a guide to accomplishing them in accordance with your wishes.

Michael O’Halloran MD, FAAP
(Revised March, 2016)

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