Ask the Medicare Specialist

QUESTION:

From Christie: Hello, I’ve read your series, “New to Medicare” and saved it. But, as you know, it’s still very confusing. I signed up for Medicare Part A last year and need to be 66 and 2 months for full Social Security benefits. I’m thinking of retiring in October or November. I have XYZ insurance through my employer and I would like to stay with that company for my Medicare plan. However, I have no idea what I need to do from now until then. Can you advise me please?

ANSWER:

Before signing up for any Medicare plan, someone in your position, already on Part A and still working past age 65, must first sign up for Medicare Part B. Here is the process: You need a “Request for Employment Information” form, which consists of two pages. You can print one out online or we can provide it to you or anyone else for that matter, as well as walk you through the steps again if need be. The first page must be filled out and signed by your employer, verifying that you’ve had health insurance since turning 65. The second page needs to be completed by you and includes personal information. Those forms then need to be provided to your local Social Security office. I suggest making an appointment with Social Security to speak to a representative as soon as you know when you’re going to retire because it takes about six to eight weeks from the time you make an appointment until you get your new Medicare card in the mail. You can have a consultation, which are always no cost, with myself or another of our licensed agents before applying or while waiting for your new card to come in. And you can actually enroll in a plan as long as we know that your Medicare Part B has been or is going to be processed. As far as making your selection in plans, there is one statement Christie made that concerns me. She has XYZ insurance (CMS regulations state I can’t mention Medicare Advantage or Part D companies by name) and wants to stay with that provider when she goes on Part B and no longer has employer coverage. Here’s the problem I have with that logic of choosing a Medicare plan. What health insurance provider you have or had while working should have nothing to do with the choice you make for several reasons. First, it doesn’t guarantee better benefits or pricing. As far as a Supplement, if Christie chooses letter plans N or G from the company she has now, she could pay as much as $77 more per month for Plan N and $33 for Plan G. And remember because all Medicare Supplement companies and plans are regulated to provide the exact same medical benefits and access to doctors and hospitals nationwide, Christie would get nothing for the extra $400 to $900 per year in premium. If she chose an Advantage Plan with the same company she currently has, there’s also a good chance of overpaying premiums and having larger co-pays. That company now has four different entities, and only one of the four provides what I consider to be competitive plans, while another doesn’t provide access to both of the largest hospital systems in our area. The two most widely held plans cost from $30 to $75 more per month than the most popular among our clients. They also have a 5-day hospital co-pay that’s almost $1,000 higher and don’t offer comprehensive dental or Over the Counter (OTC) benefits. Another consequence of making one’s Medicare choice based on what company he or she was with while employed is the possibility of not being given the option of choosing a Supplement. I can’t even count how many people I’ve met who told me they just called that company and were given only the Advantage HMO and PPO options. Advantage Plans can work great for people who choose those that offer the best value in terms of low premiums and co-pays along with generous ancillary benefits such as dental, vision, hearing, OTC, etc. However, many people who have pre-existing conditions have only one chance in their life to enroll in a Supplement, six months to one year from when they first go on Medicare Part B. I practically insist these folks go the Supplement route because they can always go back to an Advantage Plan down the road because they are required by CMS to accept anyone who Medicare Parts A and B, regardless of current or previous health conditions. Supplement companies are not. They can discriminate as far as who they accept in their plans. Again, except for those going on Medicare Part B for the first time and a couple other somewhat rare events. The wisest decision is to make an appointment with myself or another of our licensed and experienced agents. We are brokers, appointed to provide plans from every competitive Medicare Supplement and Advantage Plan on the market, ensuring unbiased advice. If you have questions regarding this or any other Medicare related topic, please give us a call or email me personally at aaron@getyourbestplan.com.