Medicare Enrollment Hazards

To avoid all of the following “Hazards”, call me and plan your Medicare enrollment. Call me 30 to 60 days before the 1st day of the calendar month when you turn age 65

Receive FREE help planning your Medicare enrollment.  Many people receiving enrollment assistance also obtain Medicare Supplement or Medicare Advantage coverage through me.  I represent 15 Medicare Supplement and Medicare Advantage companies who pay me.

Who must sign up for Medicare:

If you’re not getting retirement benefits from Social Security or the Railroad Retirement Board (RRB), to get Medicare you must sign up (Enrollment is not automatic).

Do not delay enrolling in Medicare because of delaying Social Security benefits:

You may decide to delay receiving Social Security benefits; but do NOT delay receiving Medicare benefits!  Delaying Medicare Part B enrollment may result in lifetime late enrollment penalties.

When considering delaying Social Security Benefits:

If you do NOT receive Social Security Benefits, Medicare Part B premium increases are not limited by that year’s annual Social Security cost-of-living adjustment.  (Because of the “hold harmless” provision), individuals who have their Medicare Part B premiums deducted directly from their Social Security checks, also have Part B premium increases limited to that year’s annual Social Security cost-of-living adjustment.

Penalty for delaying Medicare enrollment for 12 months:

If people delay Medicare Part B enrollment for 12 months or more after becoming eligible, many will be hit with a permanent penalty added to their Part B monthly premium.

Problem caused by enrolling in Medicare too soon:

To receive guaranteed issue Medicare Supplement coverage, you must sign up within 6 months of Medicare Part B starting.  Without guaranteed issue, you must be healthy enough to qualify for coverage or it may be denied.

If you start Part B coverage before leaving Active Employment Group Health coverage, your six-month availability of guaranteed Medicare Supplement coverage starts with the first day of Part B coverage: even if you remain on your Active Employment Group Health plan.

Good recommendation: Contact me to plan your Medicare Part A & Part B enrollments.

Gary Smith, CA Insurance License # 0631991

707-576-8100 Office, 707-478-0210 Cell (call or text)

Gary@SmithBrokerage.com (email)

 

Active Employment Group Health insurance is employer group health coverage, while actively working for the same employer providing the group health insurance.  Active Employment Group Health insurance is also employer group health insurance obtained through a spouse who actively works for the employer providing the group health insurance.

Enrollment months with Unique and Important rules:

Be extra cautious if you plan to leave Active Employment Group Health insurance, during any of the three calendar months following your age 65 birthday calendar month.

If you enroll in Medicare Part A or B during any of the 3 calendar months following your age 65 birthday month, Medicare Attained Age rules determine your start date for Medicare Part A & B.   In calendar month 4 (& beyond) following your age 65 birthday month, Active Employment Group Health Departure rules determine your start date for Medicare Part A & B.

Medicare Attained Age rules: If your age 65 birthday month is January, you can enroll in Medicare Part A & B from October through April.  If you enroll in Medicare Part A or B during October, November or December; coverage starts January 1st.  If you enroll in January, Medicare coverage starts February 1st.  If you enroll in February, Medicare coverage starts April 1st.  If you enroll in March, Medicare coverage starts June 1st.  If you enroll in April, Medicare coverage starts July 1st.

Good recommendation: Contact me to plan your Medicare Part A & Part B enrollments.

Gary Smith, CA Insurance License # 0631991

707-576-8100 Office, 707-478-0210 Cell (call or text)

Gary@SmithBrokerage.com (email)

 

Medicare Active Employment Group Health Departure rules:   Active Employment Group Health insurance is described above.

When you or your spouse stops actively working for the employer providing your group health insurance, you have 8 months guaranteed right to enroll in Medicare Parts A & B.

If you or your spouse cancel group health coverage while actively working for the employer providing your group health coverage, you have 8 months to enroll in Medicare Parts A & B.

If you enroll in Medicare during any of the preceding 8 months, your Medicare coverage starts the first of the following month.  EXCEPT during the three calendar months following your age 65 birthday calendar month.  In the preceding three months, Medicare coverage starts as describe in Medicare Attained Age rules.

Non-Active employment coverage:  

Ending Non-Active employment group health insurance does NOT guarantee enrollment in Medicare Part A & Part B.  Medicare guarantees Part A & B coverage for eight months, after ending Active Employment Group Health coverage.  Medicare does NOT guarantee Part A & Part B enrollment, after ending Non-Active employment coverage.  COBRA continuation coverage and employer retirement coverage are two examples of Non-Active employment coverage.

Good recommendation: Contact me to plan your Medicare Part A & Part B enrollments.

Gary Smith, CA Insurance License # 0631991

707-576-8100 Office, 707-478-0210 Cell (call or text)

Gary@SmithBrokerage.com (email)

 

Potentially confusing “Open Enrollment”:

Do NOT be confused by yearly “Open Enrollment” running from October 15th through December 7th.  This yearly “Open Enrollment” guarantees acceptance into a Medicare Advantage plan, which requires prior enrollment in both Medicare Part A & B.  This yearly “Open Enrollment” also guarantees acceptance onto a Medicare Part D prescription drug plan, which requires either Medicare Part A or Part B prior enrollment.

Enrolling in Medicare Part A or B while continuing an HSA:

The IRS may penalize you, if you contribute to a Health Savings Account while enrolled in Medicare Part A or Part B.  Many “Retirement” Health Savings Accounts are not penalized.  Contact me to discuss your HSA.

How to use this section’s contents:

This document was written to give readers many reasons to seek help, 30 to 60 days in advance of starting Medicare Part A or Part B coverage.  However, when planning Medicare Part A or B enrollment during the three calendar months following your age 65 birthday calendar month, call me 90 to 120 days in advance.

The language in this document was intentionally changed from wording used by Medicare.  Reading something written two different ways frequently helps people to better understand a subject.

For Medicare’s descriptions: Click Here to download The Centers for Medicare & Medicaid Services publication “Understanding the Order of Medicare Part A & Part B Enrollment Periods”.

Also visit the following links:

www.medicare.gov

Sign up/change plans

Signing up for Part A & Part B

 

Good recommendation: Contact me to plan your Medicare Part A & Part B enrollments.

Gary Smith, CA Insurance License # 0631991

707-576-8100 Office, 707-478-0210 Cell (call or text)

Gary@SmithBrokerage.com (email)

 

 


Helpful links regarding Medicare coverage:

The following link leads to part D, prescription drug coverage tab. I routinely have people use the following link to enroll in Part D.
https://www.medicare.gov/part-d/index.html

Link to Medicare’s blog:
http://blog.medicare.gov/

 


What types of Medigap policies can insurance companies sell?

The information below was taken from, 2015 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare
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In most cases, Medigap insurance companies can sell you only a “standardized” Medigap policy. All Medigap policies must have specific benefits, so you can compare them easily. If you live in Massachusetts, Minnesota, or Wisconsin, see pages 42-44.

Insurance companies that sell Medigap policies don’t have to offer every Medigap plan. However, they must offer Medigap Plan A if they offer any Medigap policy. If they offer any plan in addition to Plan A, they must also offer Plan C or Plan F. Each insurance company decides which Medigap plan it wants to sell, although state laws might affect which ones they offer.

In some cases, an insurance company must sell you a Medigap policy, even if you have health problems. Here are certain times that you’re guaranteed the right to buy a Medigap policy:

When you’re in your Medigap Open Enrollment Period. See pages 14-15.
If you have a guaranteed issue right. See pages 21-23.

You may be able to buy a Medigap policy at other times, but the insurance company can deny you a Medigap policy based on your health. Also, in some cases it may be illegal for the insurance company to sell you a Medigap policy (like if you already have Medicaid or a Medicare Advantage Plan).

What do I need to know if I want to buy a Medigap policy? (continued)

  • Although some Medigap policies sold in the past covered prescription drugs, Medigap policies sold after January 1, 2006, aren’t allowed to include prescription drug coverage.
  • If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D) offered by private companies approved by Medicare. See pages 6-7.
  • To learn about Medicare prescription drug coverage, visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

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