“Do I need to do anything with Medicare? I’m turning 65 soon”

As is common of insurance questions, the answer is a definite maybe. There are various scenarios for people turning 65, and your specific situation will dictate the answer to this question. Here are a few scenarios:

1.) “I’m turning 65 and do not have creditable group health insurance.”

This person could have an “under-65-year-old” health insurance plan that they are paying for. They may have no health insurance at all, or they may have a group health insurance plan that is not considered creditable coverage (coverage that is at least as good as Medicare). People in these situations should check with the benefits administrator at their workplace.

Regardless of the exact scenario, people in this category will need to sign up for Medicare Parts A&B through Social Security. If they happen to be collecting a monthly Social Security check, they may have been automatically enrolled and will get information mailed to them. If they are not receiving a SS check and do not plan to start receiving one for several months or longer, they will need to proactively apply.

2.) “I have creditable group health insurance coverage at work and plan to continue working. There are fewer than 20 employees in my company. What do I need to do with Medicare?”

If there are fewer than 20 employees in the company, Medicare pays first if there is a claim. People in this category should check with the benefits administrator at their workplace. According to “Medicare & You 2015”:

“If your employer insurance is the secondary payer, you might need to enroll in Part B before your insurance will pay.”

Another option would be to drop the group health plan and purchase Medicare Part B, along with a Prescription Drug Plan (Part D) and either a Medigap or a Part C plan.

3.) “I have creditable group health insurance coverage at work, and I would like to continue with it. There are more than 20 employees in my company. What do I need to do with Medicare?”

In the case of more than 20 employees in the company, the company’s insurance would pay first, so people in this category would not necessarily need to purchase Part B. They would have the option to drop their group health plan and purchase Medicare Part B, along with a Prescription Drug Plan (Part D) and either a Medigap or a Part C plan.

It is very important that a person review their particular situation 3-6 months before they turn 65 so that they understand their options and know what they need to do before reaching this milestone.

It is also important that a person has a good idea of what their over 65 health insurance will look like as part of their retirement planning. Depending on a person’s situation and the coverage options they have, they might have higher annual out of pocket costs than they anticipated.

We’ll go over that in more detail next month. For now please share this blog if you know someone who could benefit from the information, or take a look at our previous Medicare blog.