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Common Medicare Questions

There are specific requirements you must meet to be eligible for Medicare. Check your Medicare eligibility.

Medicare consists of four basic parts: Part A, Part B, Part C and Part D. Generally, the different parts of Medicare help cover specific services. Our advisors can help determine the combination of these four parts that is right for you.

How and when you should enroll in Medicare is largely dependent on your personal situation. Your eligibility period and plan options can all be impacted by your employment status, benefits you may already receive such as Social Security, your health needs and more. Keep in mind that you do not need to be retired to enroll into Medicare. Many times, Medicare is a more cost-effective solution. The best way to make sure you understand what to do and when is to speak with one of our advisors 1-866-600-5638.

If you are considering working past 65, you likely have questions about whether you need to take Medicare even though you’re still working, including whether or not you should delay Medicare Part B, how Medicare works with your Health Savings Account, how Medicare works with your employer’s health insurance and more. Give us a call at 1-866-600-5638 and we’ll answer any questions you may have.

Depending on your individual situation and health care needs, customized coverage can be established through a combination of Medicare Parts A, B, C and D. We know the different steps needed to apply and are here to provide assistance and instruction. If you want more comprehensive coverage with extra benefits, schedule an appointment. with one of our expert advisors to explore additional coverage options.

If you are 65 and older and have been employed for at least 10 years under Medicare-covered employment while paying Medicare taxes, and you have been receiving Social Security benefit checks, you will automatically be enrolled in Part A & B, even if you choose to continue to work. If you only wanted Part A, you would need to take additional steps to enroll and refuse Part B. We can help walk you through these steps and options as they are dependent on your unique situation and could have penalty implications if not navigated appropriately.

A Retiree Health Insurance Plan is health care coverage an employer may provide to its former employees after retirement. In most cases, retiree policies act as a secondary payer to Medicare, meaning the retiree policy will cover some – if not all – of the remaining medical expenses after the primary insurer (Medicare) has paid for the approved service.

Check with your employer’s benefits team to learn more about the coverage offered through their retiree health coverage program, and also contact an advisor to compare coverage types and discover which option would be the most cost-effective and beneficial for you.

If you plan to work past the age of 65, there are still several important Medicare items to consider around the time of your 65th birthday, including:

  • If you work for a company with more than 20 or more employees and receive health care benefits through your employer, you may not need to enroll in Medicare. However, Medicare can be a cost-effective solution when compared to group plan or employer coverage.
  • Have you been employed for at least 10 years and have paid Medicare taxes? If so, you will automatically be enrolled for premium-free Medicare Part A if you are drawing social security, even if you choose to continue to work. If you do not meet the work history requirement, you can still enroll in Medicare Part A; however, it is important that you compare the coverage and costs of Medicare Part A to that of your employer as it may make more sense to remain on your employer’s health coverage plan.
  • If you or your spouse is still working for a company with more than 20 employees and/or if you receive low-cost health insurance through your or your spouse’s health employer, you may want to consider delaying enrollment for Medicare Part B. If you choose to delay Part B, you will not be hit with monthly premiums just yet.
  • Does your current employer have more than 20 employees and offer a high deductible health plan that features a Health Savings Account (HSA)? If so, you may want to consider delaying enrollment for Part A. If you elect to enroll in Part A, your employer will no longer be able to contribute to your HSA. You must stop contributing to your HSA six months before you enroll in Medicare Part A.

The answer to this depends on what type of coverage you received while on your employer’s group plan and the type of coverage you’re looking for through Medicare. Enrolling in Original Medicare may not cover everything you’re used to having covered through your employer as it does not include a prescription drug plan or cover extras like, vision, dental or hearing. However, if you choose to enroll in a Medicare Supplement (see below) or a Medicare Advantage (MA) plan, you can enjoy benefits that are similar to your employer’s health care plan and possibly even more! In fact, many Medicare Advantage plans now include allowances for eyewear, over-the-counter pharmacy and rewards for healthy behaviors. These added benefits provide extra cost savings that aren’t necessarily included in an employer plan.

Veterans who are eligible to receive health care benefits like Tricare for Life (TFL) or Veterans Affairs are not required to enroll in Medicare. However, they might benefit by exploring their Medicare eligibility to receive more coverage, broader selections for physicians and treatment facilities, and supplemental benefits at little or no cost by adding on a Medicare Advantage (MA) Plan. Veterans who sign up for Medicare Advantage will continue to have access to their TFL and VA coverage. These plans work together to enhance the overall benefits.

The contributions made by both yourself and your former employer to your Health Savings Account (HSA) will not be affected. The money accrued during your employment is yours to use towards qualified expenses when needed. However, individuals who choose to enroll in Medicare Part A and continue to work after 65 can no longer receive HSA contributions from their employer. It is important to note that any individual who plans to enroll in Medicare Part A must stop contributing to their HSA six months before enrollment.

There are several Individual Health Insurance Plan options available to you, and the types of coverage and cost may vary. Call one of our expert advisors at 1-866-600-5638 for assistance in narrowing down these options to find the right health coverage plan for your individual needs. We’re ready to help.

If your spouse is not currently working or is not eligible to receive health care coverage through their employer, additional options for coverage include:

  • Purchasing an individual health insurance plan. We can help you narrow down your options and find the right plan for you. Call us today, we’re ready to help.
  • Applying for Medicaid, a public health insurance program based primarily on income and family size. Additional criteria for eligibility vary from state to state.
  • Applying for temporary Consolidated Omnibus Budget Reconciliation Act (COBRA) insurance. COBRA allows individuals who have left or lost a job, as well as their spouses and children, to continue to receive health care coverage through the individual’s former employer by paying full premiums.

Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) plans include deductible and copay cost-sharing features, and typically have lower premiums than Medicare Supplement plans. In addition, individuals on an MA or MAPD plan may also receive additional benefits such as vision, hearing and some dental coverage.

Medicare Supplements, also referred to as Medigap plans, are exactly as they sound – they are designed to supplement and “fill the gaps” of original Medicare by paying the deductibles and coinsurance for Medicare-covered services. It is important to note that supplement coverage is secondary to Medicare and will only cover Medicare-approved services. In addition, Medicare Supplements do not provide prescription drug coverage so many individuals pair a stand-alone Prescription Drug Plan (PDP) with their Medicare Supplement to help cover the costs of prescription medications. If you travel frequently, this option might be a good fit for you as this plan goes wherever you go.

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