Posts Tagged ‘Medicare Part B’

How Medicare Coordinates with Employer Health Care

Wednesday, September 5th, 2018

If you’re 65 or older, working and have an employer group health plan based on your current work, you may have questions about how your job-based insurance coordinates with Medicare. On the Medicare Rights Center National Consumer Helpline, such questions are among the most frequent ones we get. Here’s what you need to know:

For people who work and have job-based insurance, knowing when to enroll in Medicare falls on them. There is no formal notification from the Social Security Administration or Medicare. Some people are misinformed by employers or don’t have reliable information about Medicare enrollment, leading them to delay enrollment in Medicare Part B and then incur penalties and high medical costs.

The Rules on Coordinating Medicare and Employer Coverage

Having job-based insurance does allow you to delay Medicare enrollment without penalty and delay paying the Medicare Part B premium (the standard Medicare Part B premium is expected to be $134 a month in 2019). However, it’s important to know whether your job-based insurance will pay primary or secondary to Medicare.

In most cases, you should only delay enrollment in Medicare if your job-based insurance is the primary payer (meaning it pays first for your medical bills) and Medicare is secondary. There are additional enrollment considerations if you have a Health Savings Account (HSA); if you enroll in Medicare Part A and/or B, you can no longer contribute pre-tax dollars to your HSA.

Job-based insurance is primary if it is from an employer with 20 or more employees. Medicare is secondary in this case, and some people in this situation choose not to enroll in Medicare Part B so that they do not have to pay the monthly premium.

Job-based insurance is secondary if it is from an employer with fewer than 20 employees; Medicare is primary in this case. If you work at an employer this small and delay Medicare enrollment, your job-based insurance may provide little or no coverage. That’s why you should enroll in Medicare Part B to avoid incurring high costs for your care. The rules are different, however, if you are Medicare-eligible due to a disability or because you have End-Stage Renal Disease (ESRD).

The Medicare Special Enrollment Period

If you are eligible for Medicare because you are 65 or older and are covered by your job-based insurance or your spouse’s, you have a Special Enrollment Period (SEP) to enroll in Medicare Part B while you are covered by job-based insurance and up to eight months after you no longer have that coverage. This means you aren’t required to take Part B during your Initial Enrollment Period (IEP), or the seven months surrounding your 65th birthday, when you become Medicare eligible.

Using the Part B Special Enrollment Period means you will not have to pay a Part B late enrollment penalty (LEP). Normally, for every 12 months that people who are Medicare-eligible and not covered by employer insurance delay enrollment, they accrue a 10% penalty, which is then added to their monthly Part B premium amount. In most cases, the penalty lasts for as long as someone has Medicare.

Retiree Coverage, COBRA, Affordable Care Act and Medicare

Many Medicare-eligible individuals do not know that employer-offered retiree coverage is almost always secondary to Medicare.

Similarly, health insurance coverage through COBRA (employer-sponsored coverage you can pay to keep after you leave your job, usually for up to 18 months) is also always secondary to Medicare coverage. If you have employer-offered retiree coverage or COBRA, you should enroll in Medicare when first eligible to avoid possible penalties, higher medical costs and gaps in coverage.

You should also make sure you understand how to make Medicare Part B enrollment decisions if you are enrolled in a Marketplace plan under the Affordable Care Act.

If you have an insurance plan certified by the Marketplace, known as a Qualified Health Plan, deciding what to do as you approach Medicare eligibility depends on your circumstances. If you delayed enrolling in Medicare so you could stay in your Marketplace plan, you may be eligible to request time-limited equitable relief. That will let you enroll in Medicare Part B without penalty or eliminate or reduce your late-enrollment penalty under certain circumstances. The opportunity to request time-limited equitable relief lasts until September 30, 2018.

Source:  Written by Joe Baker, Next Avenue Contributor, linked via Forbes.  Original content here.

In the Northwest Ohio area please contact either Natalie Grieser or Bill Beck at Beck Insurance Agency for more information.  Beck Insurance Agency is located at 120 N Defiance Street in downtown Archbold, Ohio.  Phone 419-446-2777.  Natalie Grieser email is Natalie@beckinsurance.com , Bill Beck email is bbeck@beckinsurance.com.  Or click here to contact via the Beck Insurance website for more information on medicare.

Medicare benefits: 7 frequently asked questions

Thursday, July 12th, 2018

Here are seven things all Americans should know about Medicare

Medicare covers, or will eventually cover, virtually all American workers, but this massive health care program isn’t well understood by millions of people. Many don’t know when they will become eligible for Medicare, what it covers (and doesn’t), and what it costs.

With that in mind, here are seven frequently asked questions about Medicare and the answers to each.

1. When can I get Medicare benefits?

Unless you’re disabled, the answer is 65 years old. A common misconception among Americans is that you can get Medicare as soon as you claim Social Security benefits, which can be as early as age 62. Unfortunately, even if you retire early and claim your Social Security benefit early, you’ll have to wait until 65 before you’ll be covered for Medicare.

2. How do I apply for Medicare?

You may not have to. If you’re already receiving Social Security retirement benefits when you turn 65, you’ll be enrolled in Medicare automatically. If this is the case, you’ll be automatically enrolled in Parts A and B of Medicare (more on the parts in a bit), and you can expect to receive your Medicare benefits card about three months before you turn 65.

If you aren’t receiving your Social Security retirement benefit when you turn 65, you’ll have to apply for Medicare, which you can do quite easily on the Social Security Administration’s website. Your initial enrollment period begins three months before the month of your 65th birthday and extends for three months after.

3. What are the “parts” of Medicare?

There are four “parts” of Medicare. Here’s a quick rundown, along with links to learn more about each part:

•Part A is Hospital Insurance, or HI. This primarily covers hospital stays and some stays in skilled nursing facilities.
•Part B is Medical Insurance. This covers doctors’ visits, lab tests, and outpatient procedures, just to name a few.
•Part C is Medicare Advantage. These are plans offered by private companies to provide Medicare benefits.
•Part D is Prescription Drug Coverage. This is optional for beneficiaries.

Parts A and B are collectively referred to as “Original Medicare,” and are generally what’s being referred to when I use the term Medicare.

4. How much does Medicare cost?

Medicare Part A is free for the vast majority of American seniors, but has a deductible of $1,340 per benefit period, as well as coinsurance requirements if your hospital stay lasts more than 60 days or if your skilled nursing stay extends beyond 20 days.

Medicare Part B has a monthly premium. For 2018, the standard monthly premium is $134, but high-income seniors pay significantly more than this. At the high end, seniors with incomes over $320,000 (joint tax return) or $160,000 (individual) have to pay $428.60 per month. In addition, Medicare Part B has an annual deductible of $183 for 2018.

Part D, prescription drug coverage plans, come with an average monthly premium of $35.

5. What does Medicare not cover?

One of the most important things for seniors to know is what Medicare doesn’t cover. While this isn’t an exhaustive list, Medicare doesn’t cover long-term care, dental care, eye exams or glasses, dentures, acupuncture, hearing aids, and routine foot care.

This list is what Original Medicare (Parts A and B) doesn’t cover. Certain Medicare health plans may cover some of these services.

6. What is Medigap?

Since there are many copays and deductibles, private insurers sell Medicare Supplemental Insurance Plans, or Medigap plans. There are 10 different varieties of Medigap plans, with Medigap Plan F (the most comprehensive) the most commonly chosen option. While Medigap plans are standardized in terms of the coverage they provide, costs can vary significantly.

7. I have health insurance already through an employer. Do I have to enroll in (and pay for) Medicare at age 65?

It depends what kind of health insurance you have. If you have insurance through your employer or your spouse’s employer and the primary insured is still working, you may not be required to enroll in Medicare as long as the company sponsoring your coverage has at least 20 employees. In this case, you’ll have a special enrollment period after you (or your spouse) retire or leave that employer.

On the other hand, if your insurance is through an employer you’ve already retired from, you still have to sign up at 65. If you are required to sign up for Medicare Part B, and don’t, you’ll face a permanent penalty of 10% of the Medicare Part B premium for every year you were supposed to enroll but didn’t.

It’s also worth noting that since Medicare Part A is free, it generally doesn’t make sense to delay signing up for it, even if you’re not required to. Your employer’s insurance will be your primary coverage, and Medicare will be secondary. However, since Part B comes with a premium, it does make sense to wait if you’re still covered by your employer’s plan.

Source of this content is Matthew Frankel of The Motley Fool via USA Today. Original link found hereShould you want more information on Medicare and Medicare Supplements please call Beck Insurance Agency at 419-446-2777 and ask to speak to either Bill Beck or Natalie GrieserOr click here to request a call back.

What Makes a Medicare Advantage Prescription Drug Plan a Smart Choice?

Thursday, November 2nd, 2017

Like many people, you may take a prescription medicine or two … maybe more. And those costs can really add up, especially people who are 65 or older and are on a fixed income. That’s why you might want to consider adding a prescription drug plan to your Medicare coverage.

 It’s Easy to Get Medicare Prescription Drug Coverage

You may already know Original Medicare doesn’t cover the drugs you buy from a pharmacy. But you can easily get prescription drug coverage, known as a Medicare Part D Plan, from private companies in two ways:

1. A stand-alone Prescription Drug Plan (PDP), which you can add to Original Medicare or a Medicare Supplement insurance plan.
2. A Medicare Advantage plan (Part C) that includes prescription drug coverage.

About Medicare Advantage Prescription Drug Plans

A Medicare Advantage plan with prescription drug coverage, also called an MAPD plan, can be a great choice because it includes all the benefits of Medicare Parts A (hospital insurance) and B (medical insurance) as well as drug coverage.

Medicare Prescription Coverage and More in Simple, All-in-One Plans

MAPD plans are approved by Medicare to provide your Parts A and B benefits — plus they cover prescription drugs and extra benefits that Original Medicare doesn’t. By bundling everything together, these MAPD plans make controlling Medicare drug costs and managing all aspects of your medical care easier.

With an MAPD plan, you’ll also receive low monthly premiums, an annual limit on out-of-pocket costs, and additional options that could include wellness programs, fitness memberships, dental, vision and hearing benefits, and more.

Choosing the MAPD Plan That Fits Your Needs

When considering MAPD plans, you’ll want to take into account their coverage and their costs, which can include monthly payments, deductibles, copayments and/or a percentage of a service or drug’s overall cost.

To make the most of your MAPD plan’s Medicare prescription drug coverage, here are a few things to keep in mind:
• All MAPD plans have a list of covered drugs, known as a formulary. It’s required to include common types of drugs, but not specific drugs within each type. Check to make sure any medications you need are included in your plan’s drug list.
• MAPD drug lists place medications into three to six different “tiers” or levels of cost to you. Drugs listed in lower tiers may be generic and generally cost less than drugs listed in higher tiers.
• MAPD plans can specify which pharmacies you must use. If you get a prescription filled by a pharmacy that’s not in your plan, you may pay more or all of the cost.
• Find out if you can save by using a mail-order pharmacy, which typically supplies a two- or three-month refill for a single copayment.

Remember, prescription plans for Medicare (Part D) are optional and you don’t automatically get one with Original Medicare. You have to choose Medicare prescription coverage from a private company. It’s best to make your Part D choice during your Initial Enrollment Period, because if you wait more than 63 days you may be subject to a late enrollment penalty. And when you get Part D bundled into a Medicare Advantage plan that includes prescription drug benefits, your MAPD will give you valuable all-in-one coverage.

Call Beck Insurance Agency at 419-446-2777 to schedule your appointment today!

Please note: Some Medicare Advantage plans do not cover prescription drugs, so be sure the plan you choose is an MAPD plan if you want it to include prescription drug coverage.
eptember 07, 2017

Medicare Supplements

Thursday, October 12th, 2017

If you are medicare eligible now is the time to compare plans and prices for your medicare supplement plans, advantage plans, and prescription drug plans.  Beck Insurance Agency is your senior product specialists!!  Medicare open enrollment officially begins October 15, 2017, and ends December 7, 2017.

Please contact Beck Insurance today to reserve your appointment with one of our senior product specialists.

419-446-2777 *** info@beckinsurance.com *** Submit via Contact Us tab