FAQ’s for those turning 65 or new to Medicare

Turning 65 or new to Medicare (aging in)? We know your questions and concerns.

There is no charge to discuss your specific situation, our agency is paid a commission if you decide to enroll through us. However, we do not pressure. We are independent agents representing many carriers in Georgia and South Carolina, your needs determine the plan/carrier.

1. Will my Medicare benefits begin automatically when I turn 65? Medicare benefit cards are mailed out automatically 3-4 months in advance of your 65^th birthday IF you are receiving Social Security benefits. IF you are NOT receiving Social Security benefits, you must apply for your Medicare coverage.
2. Do I need Part D drug coverage even if I currently don’t take any prescription medicines? Coverage is not mandatory but if you elect Part D coverage after becoming eligible you may be required to pay a 1% per month penalty for each month you were without Part D coverage. This is a monthly penalty charged as long as you have Part D). Get complete details on the Part D late enrollment penalty in the Medicare and You Handbook. Those starting Medicare should review the discussions under Medicare Coverage Options
3. If I continue to work do I need to have Medicare health coverage start at age 65? This depends, consider at minimum these questions:
   a. Do you have group medical coverage
   b. What is the size of the company’s medical group
   c. Who pays first Medicare or the group plan- you may want to review Who Pays First, under our resources tab  You want to get this right for 2 reasons:   1.  Why pay a Medicare Part B premium if coverage is not required (Monthly Part B premium $148.50 or higher dependent upon income)   2. If you should enroll into Part B, do not do so, and later elect to – you will be charged a 10% penalty (of the current Part B rate)for each year you were not enrolled in Part B. This penalty is charged each month and lasts as long as you have Part B. Get complete details on the Part B late enrollment penalty in the Medicare and You Handbook. under our resources tab
4. If I have group coverage do I need to enroll into Part D drug coverage? Your medical carrier each year should mail you a letter which states if your current drug coverage is considered credible. Credible would mean your drug coverage is as good as the standard criteria established by Medicare for the Medicare Part D plans. If it is not and you do not enroll, you may be required to pay a 1% per month penalty for each month you were without credible Part D coverage. Get complete details on the Part D late enrollment penalty in the Medicare and You Handbook. under our resources tab.  Those who did not start Part B, you are now retiring and ready to start your Part B coverage should review discussions under the next section.

MEDICARE

I am ready to start my Part B benefits

Ending Group coverage: IF YOU ARE NOT RETIRING, CONTACT YOUR HR AND ENSURE YOU CAN LEAVE THE GROUP PLAN NOW.

A.  You will want to go to the Social Security Administration (SSA) to start the Part B. Let them know when group coverage will end and when you want the Medicare Part B to start. If you did not enroll when 65 they will give you a form your HR must submit to Social Security providing evidence you have had group coverage. This allows you to enroll into Part B without a penalty.

B.  You will want to make your appointment with the SSA 6 weeks or so before you plan to start Part B allowing enough time for the form to be submitted and you to receive your Medicare coverage.

C.  If you will NOT be receiving Social Security benefits, you will be billed the Part B premium.

D.  The Special Enrollment Period allows you an 8-month period to enroll after employment or coverage ends, whichever happens first. NOTE COBRA and retiree health plans, VA coverage, Individual health coverage (like through the Health Insurance Marketplace) ARE NOT coverage based on current employment.

You can find additional information in our resource tab in the Medicare and You Handbook

You should review the discussions under the tab Medicare Coverage Options 

MEDICARE

I did not start Part B at 65 but want to do so now

A.  If you did not enroll into Medicare Part B at age 65, you can only enroll during the General Enrollment Period from January 1 to March 31^st

B.  Your coverage will not start until July 1^st of that year.

C.  You will most likely be penalized 10% of the current Part B premium rate for each year you were not enrolled in Part B coverage. This penalty is charged each month and last as long as you have Part B.

You can find additional information in our resource tab in the Medicare and You Handbook

You should review the discussions under our tab Medicare Health Coverage Options

MEDICARE

FAQ’s for those turning 65 and you have had Medicare due to disability

There is no charge to discuss your specific situation, our agency is paid a commission if you decide to enroll through us. However, we do not pressure. We are independent agents representing many carriers in Georgia and South Carolina, your needs determine the plan/carrier.

1. Since I am turning 65 do I have new/additional choices of coverage? Turning 65 affords you new choices you may not have been offered under 65 and on Medicare.                                                                                                                      a. You are able to purchase a Medicare Supplement up to 6 months of turning 65- guaranteed issue. The carrier cannot ask any health questions during this time period.                                                                                                                         b. You can elect new or change a Part D prescription drug plan, or Part C Medicare Advantage plan.
2. I am currently covered under a spouses group plan. Should I now consider other Medicare choices? It is worth considering. Even though Part B has a premium, I’d suggest you compare your group medical premiums against the Part B premium + Part D premium + a Medicare Supplement premium. Additionally, make sure you know the group medical plans deductible. Some Medicare Supplement plans have no or low out of pocket health care costs. So it may be close or lower in premiums but could result in stronger health benefits.

You should review the discussions under our tab Medicare Coverage Options

MEDICARE

I applied for disability through Social Security

Once approved for disability your Medicare benefits begin on the 25^th month of disability. EXCEPTIONS: ALS benefits begin the month your disability begins. End Stage Renal Disease coverage usually starts on the first day of the fourth month of your dialysis treatments. Call Social Security to enroll.

Consider these thoughts:

1. If you are covered under a spouses group health coverage, contact the HR to determine if you should have the Medicare Part B coverage. Medicare Part B has a monthly premium.
2. If you are approved for disability, do not have health coverage nor eligible for coverage under a spouses’ plan, but have months or more with no health coverage, you may want to consider coverage through the Healthcare Marketplace. You may be eligible for a subsidy to help pay health premiums through the Market Place. However, be careful. Subsidies are based on income and if you receive a settlement for back Social Security benefits you will need to include this as income.
3. You should receive your Medicare card automatically about 3-4 months before the 25^th month of disability. If not received contact Medicare, 1-800-633-4227.

Get more information on Medicare timeframe and benefits under our resource tab in the Medicare and You Handbook

You should review the discussions under our tab Medicare Coverage Options