Understanding the Medicare Rules
Are you Turning 65 but Not Retiring ? Many people still work beyond the age of 65 , and remain on their employer ’ s group health insurance . You can keep this insurance in place and waive Medicare ' s Part B Medical insurance if you 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 ( companies with fewer than 20 employees ) requires you to take out Medicare , but not always . If you elect to stay on your group health plan , this is considered creditable coverage .
HSA Plans and Medicare : If you are still working and have an HSA compatible plan ( High Deductible Health Plan ) and you plan on still contributing to your HSA account , you cannot enroll into Medicare Parts A or B . With an HSA compatible plan , you cannot have another health plan and Medicare would be considered that . However , if you work for a company that has fewer than 20 employees , you must enroll in Medicare A & B . If you ' re not sure , contact Medicare to be absolutely sure .
Part B Penalty : If you don ' t have creditable coverage and you don ' t sign up for Part B when you ' re first eligible , you ' ll have to pay a late enrollment penalty which sticks with you for the rest of your life . You have 8 months from the time you ' re eligible to enroll in Part B , to obtain it . 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 . If you miss your Initial Enrollment Period or your Special Enrollment Period , you may have to wait until the General Enrollment Period ( from January 1 to March 31 ) to enroll in Part B , and then the coverage will start July 1st of that year .
Part D ( Prescription Drug Plan ): Medicare requires you to have prescription drug coverage either by purchasing a stand-alone Part D plan or a Medicare Advantage plan that has a drug plan built into it . 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 or Cobra 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 assets ( excluding your house ), the state may help you pay for Part B . You may also qualify for Extra Help to pay for your Medicare prescription drug coverage . This helps you lower your prescription drug copays and for many , keeps your prescription costs very low while in the coverage gap or ‘ donut hole ’. Check with Medicare or Social Security to see if you qualify or ask a local agent for guidance . If you qualify , you will have Special Enrollment Periods which allows you to enroll in any plan in each quarter every year . Feel free to contact us for help .
Our services are always free . We can be reached at : michele @ mcinsurance . com or 408-848-2271 .
8 SUMMER 2023 gmhTODAY Magazine : Go . Make history ... gmhtoday . com