I often get asked the same questions over and over regarding Medicare. So, I thought it might be interesting to share a couple of my most asked Medicare questions and answers with you.
First let me say, as with everything concerning Medicare, this is the information we know currently. Changes in Medicare policies happen frequently. Your Medicare decision should be based on your health and financial situation, not what your best friend’s neighbor did. Medicare does not have to be the same for both spouses. Take your time and review your options. Be sure you are receiving non-biased, information, in order to make your decision. Many of the Medicare decisions you make now will follow you the rest of your life. So, my advice is to learn how Medicare works and then to choose wisely.
I am turning 65 in a couple of months and was told I must sign up for Medicare. I plan to work for a couple more years before I retire. I don’t want to get stuck with a penalty. What do I need to do?
If you are covered through your employer and can keep your employer-based insurance, you don’t have to do anything, except inform Social Security that you are waiving Medicare coverage for now.
Many people do choose to pick up Medicare Part A, which is hospital coverage. Medicare Part A is free, meaning there is no premium associated with it. It works with your employer-based insurance as a secondary policy. So, if you get sick and must stay in the hospital, your employer coverage will pay first, and then the remainder is picked up by Medicare. To sign up for Medicare Part A, you need to enroll through Social Security.
During the pandemic, most Social Security offices were closed to the public, so the fastest and easiest way to sign up is through www.ssa.org or call 1-800-772-1213.
So when you do decide to retire, you will need to ask your HR Department can fill out form CMS-L564 to prove to Social Security that you have had credible coverage through your employer and now are requesting a special enrollment period to go fully onto Medicare. This document is important because it prevents you from incurring a penalty on your Part A and B coverage.
I always encourage new beneficiaries to try to not have any gaps in coverage from going from your employer coverage on to Medicare.
Can I change may Medicare coverage every year?
It depends.Medicare Part A and B do not change.
If you have a Medicare Part C/Advantage Plan you can change it every year during fall Open Enrollment (Oct. 15 thru Dec. 7) if prescription drug coverage is attached to the plan. Otherwise you can change it during Medicare Advantage Open Enrollment (Jan. 1 thru Mar. 31) each year.
Medigap or Supplement Plans typically are harder to change. If you want to make a change, you would need to apply to the company you want to move to in order to see if you would qualify for their plan. This means your health history would go through underwriting for approval. Do not drop your current coverage until you have approval to move to a new plan. It is best to chose wisely in the beginning and not have to make a change in the future.
Prescription Drug Plans can be changed every year! I encourage all Medicare Beneficiaries to review their drug coverage each fall during Open Enrollment. This is the time to review the premium and drug costs associated with your current plan and to look to see if there are other options to save you money. This decision is also influenced by your health and financial situation. The only way to know if you are in a good Part D plan is to review it on www.medicare.gov every fall.
If you would like to have help reviewing your Medicare options, we have added new volunteers who can help you to walk through this process so you can make the best Medicare decision for you!
Johnson County SHICK (Senior Health Insurance Counseling for Kansas) Program – 785-521-3315
Johnson County Extension 913-715-7000