By Michele Campbell , Independent Agent
Michele has been in the insurance business for over 25 years and specializes in Medicare , individual health and life insurance . She is passionate about helping her clients to find the right plan to fit their needs . She is an active member of the Gilroy Chamber of Commerce , Gilroy Rotary and Gilroy Leadership Class of 2015 . Visit mcinsuranceservices . com or call 408.848.2271 .
INDIVIDUAL HEALTH INSURANCE Open enrollment for individual and family plans [ Obamacare ] is over and now we move into special enrollment periods . This is for people that have special reasons to either switch plans or start a new plan . Everyone has a 60-day window to make these changes so don ’ t delay . Some reasons for the Special Enrollment Period are as follows :
• If you moved out of the area and your plan is not available in your new area .
• If you lost group coverage from an employer ( left job , changed jobs , divorce ).
• If you lost creditable coverage involuntarily ( divorce , turning 26 years old , etc .).
• If your income changed and went below the Medi-Cal threshold .
• If you lost Medi-Cal status .
• If your Cobra coverage ends .
And many other reasons … be sure to check with a professional who knows if you qualify to change or add coverage . Don ’ t be left without coverage or you could get a tax penalty .
Here are some shocking statistics about uninsured Americans and the new healthcare laws :
• Only 15 % of the uninsured understand the deadline .
• More than 7 out of 10 say they have not tried to figure out if they qualify for help .
• Only 1 in 100 know the minimum penalty for being uninsured is going up to $ 695 in 2016 .
MEDICARE INSURANCE With an average of 10,000 Americans turning 65 every day of every year until 2029 , there ’ s a stream of folks just like you now learning about Medicare health insurance . Here are some basic rules about Medicare to get you started :
New to Medicare ? Are you just turning 65 or just now retiring ? You might be feeling a little overwhelmed if this is your first time looking at Medicare and how it works . While there is a ton of information out there , it is still very confusing when you you may get help to pay for you ’ re first learning about it . First , you need to enroll in Medicare , a few months prior to turning
65 , or if you ’ re collecting Social Security , you will be automatically enrolled and your card will be sent to you . Once you get enrolled in the Medicare system , then you can purchase either a Medicare Advantage plan or a Medicare Supplement and a Part D prescription drug plan . If you ’ re not sure which way to get coverage , you can ask a professional ( Insurance Agent ) for help .
Are you Turning 65 but Not Retiring ? Many people are still working beyond the age of 65 and still have their group health insurance . You can keep your group health insurance in place and wave Medicare ’ s Part B Medical insurance if you so choose . Medicare Part A ( Hospital ) is free if you worked at least 40 quarters ( or 10 years ) in the US and paid into Medicare . Sometimes your group health insurance requires you to take out Medicare Part B , but not always . If you elect to stay on your group health plan , this is considered creditable coverage .
Part B Penalty : If you don › t have creditable coverage and if you don ’ t sign up for Part B when you ’ re first eligible , you ’ ll have to pay a late enrollment penalty for as long as you have Part B . Your monthly premium for Part B may go up 10 % for each full 12-month period that you could have had Part B , but didn ’ t sign up for it . Also , you may have to wait until the General Enrollment Period ( from January 1 to March 31 ) to enroll in Part B , and coverage will start July 1 of that year .
Part D ( Prescription Drug Plan ): Medicare requires you to have prescription drug coverage either by purchasing a standalone Part D plan or a Medicare Advantage plan . If you don ’ t purchase a drug plan or advantage plan within your initial coverage election period ( 7-month window ), you could be subject to a Part D penalty as well . If you maintain group coverage , then you have creditable coverage and you won ’ t be penalized .
Do you qualify for Low Income Subsidy ( LIS ) or Part D Extra Help ? If you have limited income and resources , you may get help to pay for Part A , and / or Part B . You may also qualify for Extra Help to pay for your Medicare prescription drug coverage . Check with a local agent to see if you qualify . If you do , you will have a year-round open enrollment to enroll in almost any plan and lowered prescription drug costs .
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GILROY • MORGAN HILL • SAN MARTIN MARCH / APRIL 2016 gmhtoday . com