Your Insurance … with Michele Campbell: There are keys to understanding Medicare rules and regulations
Published in the August 9 – August 22, 2017 issue of Gilroy Life
By Michele Campbell
Michele Campbell
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 United States 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 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.
Your monthly premium for Part B may go up 10 percent 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 1 of that year.
If you have Veteran’s Administration coverage and think you don’t have to enroll in Part B, you’re wrong. Even though the VA will cover a lot of your services, it is not considered creditable coverage for Part B.
Be sure to apply within the eight months of being eligible. I’ve seen it with my own eyes, someone who didn’t sign up for five years and was charged 50 percent more than the standard rate and this penalty sticks with him for the remainder of his life.
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 (seven 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. VA coverage is also considered creditable coverage, so this satisfies the Part D coverage.
Do you qualify for Low Income Subsidy (LIS) or Part D Extra Help? If you have limited income and assets (excluding your house), your state may help you pay for Part A, and/or Part B.
You may also qualify for Extra Help to pay for your Medicare prescription drug coverage and this help with lower your prescription drug copays and for many, keep you out of the coverage gap or donut hole.
Check with a Medicare or Social Security to see if you qualify or ask a local agent for guidance.
If you qualify, you will have a year round open enrollment which allows you to enroll in almost any plan any time of the year.
Please check with an insurance professional to outline your plans and your future regarding medical care as you reach retirement.
Michele Campbell owns and operates Michele Campbell Insurance in Gilroy. If you have any questions or need any help, please reach out for help. She can be reached at (408) 848-2271 or at [email protected].
