What is Medicare and how can it help me?
Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. You may click here to view useful information about Medicare on the government’s Medicare website. Many Americans who choose to work beyond age 65 can continue to be covered by their Employer-sponsored group health insurance plans, or sign up for Medicare. Since Medicare Part A (Hospitalization Coverage) has no charge if a worker has paid enough into the system and has enough credits (40 quarters or 10 years) many people sign up for Part A when they turn age 65 if there is no charge and delay enrolling in Part B (Professional Charges and fees) until they retire or the employer coverage is no longer available. However, you must have Part B coverage (or the equivalent of Part B coverage) or you run the risk of paying a penalty when you do want to enroll in Part B. The same goes for Part D (Prescription Drug Coverage) you must sign up for Part D coverage when you become eligible (unless you maintain equivalent coverage) or you will be assessed a penalty when you do want to enroll in a Part D Prescription Drug plan.
What is the Medicare ‘Initial Enrollment Period’?
The Medicare ‘Initial Enrollment Period’ is a 7-month period that begins 3 months prior to your birthday month – your birthday month and continues for the 3 months following the month you turn age 65. If you do not enroll in Medicare Parts B & D during this time and do not have equivalent coverage in force you will face a penalty when you decide to enroll. In addition, you must wait for an ‘Open Enrollment Period’ and coverage will not be effective until a future date.
If you have Employer-sponsored group health coverage available to you and you will continue working beyond age 65 it is important to analyze the cost for you and your dependents between Medicare and the employer plan. As mentioned above there is no cost for Medicare Part A if you have 10 years of credits paid into the system. You may buy into Part A if you do not have enough credits paid into the system. The cost of Medicare Parts B & D varies and is now means tested, the regular cost of Part B in 2023 begins at $164.90 and increases based on your Modified Adjusted Gross Income. The cost for Part D is the plan premium you select up to certain income levels and then increases. Please click here to view the CMS Publication that lists the cost for Parts B & D for those with higher incomes.
Kelley Insurance will help you navigate your Employer-sponsored plan
We will review this information along with the information from your Employer-sponsored group plan (if applicable) with you in order to determine if staying in your group plan or enrolling in Medicare is best for you. If you elect to delay your Part B & D enrollment you must maintain equivalent coverage and when you later decide to enroll in Parts B & D you will have a ‘Special Enrollment Period‘ in which to enroll in Parts B & D. A Certificate of Coverage will be required from your prior plan in order to prove that you have had equivalent coverage so the penalties will not apply.
Will Medicare alone cover everything I need?
Original Medicare Parts A & B may not be enough coverage – along with a Part D Prescription Drug plan. Many people elect to purchase a Medicare Supplement plan in order to provide additional coverage for the gaps in Original Medicare. Here at Kelley Insurance & Financial, we specialize in working with you to select the best Medicare Supplement for your situation. We are independent brokers and provide a wide range of Medicare Supplement carriers and plans for your consideration.
How does being self-employed impact my Medicare status?
Many of the people that we work with who purchase Medicare Supplement and Part D Prescription Drug coverage are still working and self-employed. Self-Employed individuals may be able to deduct a portion or all the premiums they pay for tax purposes. Therefore we will work with you to be sure you are getting every possible deduction and paying premiums as efficiently as possible.
In addition, so that you do not have to spend your valuable time on hold waiting for a ‘Call Center’ representative after your enrollment – we provide you with professional customer service and support by assisting you with claims issues, billing, and administrative questions. Please contact our office today in order to get the information you need for you and your family to make the best decision for your health care.