April 22, 2013

To Enroll Or Not To Enroll: That Is The Question

By Donna Kemp, founder of Premier Senior Insurance

Enrolling in Medicare Part B if you are age 65 or older, still working (or spouse is still working) and have insurance coverage from that job.

First things first, you should know that your Initial Enrollment Period begins three months before your 65th birthday and ends three months after your 65th birthday. Then you need to consider if you or your spouse will continue to keep working after this time and if either will be receiving health insurance from that current employer. If the answer is "Yes", your current employer insurance will be your primary coverage if there are 20 or more employees at that company.

On the other hand, if there are fewer than 20 employees, Medicare will be considered your primary coverage. You should then consider enrolling in Part B because you will have no primary insurance, which is basically like having no insurance at all.

If you or your spouse has decided to keep working and receives employer coverage, you may opt out of signing up for your Part B Medicare insurance during your Initial Enrollment Period (IEP). It is always a good idea to talk to your employer when you first become eligible for Medicare to see how your employer insurance will work with Medicare.

"What if I am already collecting Social Security when I turn 65"? I am glad you asked. In the event you are already collecting Social Security when you turn 65, you will be automatically enrolled in both Medicare Part A and Part B. You have the option at this time to decline signing up for Part B but you will need to make sure you return the Medicare card and form you receive in the mail stating that you do not want Part B at this time due to current employer coverage. You will then receive a new Medicare card in the mail that does not have Part B Medicare insurance.

In either case, if you have insurance from a current employer you will qualify for what is known as a Special Enrollment Period (SEP). While you are in this Special Enrollment Period you are permitted to enroll in Part B at anytime as long as you or your spouse are still working and for up to eight months after you lose your employer coverage or stop working. During this period, you can enroll in Part B without penalty.

Another question I get asked a lot, "Is my COBRA or retiree insurance considered current employer insure"? The answer to that question is "No". They are not considered current employer coverage and you will not have a Special Enrollment Period if you have COBRA or retiree insurance. If you have COBRA or retiree insurance and postpone enrollment in Part B you may have to pay a penalty when you are ready to sign up.

There are a lot of rules surrounding Medicare, so be careful when you do make any decisions whether to enroll at age 65 or you choose to wait to enroll. Some changes could lead to penalties or worse, no coverage at all when you need it most. Don't assume all agents know these rules. Work with a trusted advisor. An Advisor is someone who listens to you and helps you find a plan that is right for you based on all the options available.

If you'd like more information, please contact Donna Kemp at 937-569-4048 or e-mail her at dkemp@premierseniorinsurance.com .

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