Paid Advertisement Ask the Medicare Specialist by: Aaron Zolbrod Welcome to Part 3 of the series, "New to Medicare," which I'm writing to help guide those who will soon be going on Medicare Parts, A. B, or both. If you've missed the previous columns, you can read them on our website as well as listen or watch the podcast and webcast versions. QUESTION: I Do I have to enroll in Medicare when I turn 65 ir Im still working? Are there penalties for not doing so? Who should and shouldn't enroll in Medicare? ANSWER: It's not necessary to enroll in Part Bat age 65 when one is getting health insurance through their own or a spouse's employer And in this case, when opting out, there are no late enroliment penalties, the details of which I will explain shortly. In addition, people on employer plans can enroll in Part B during any time of the year when they decide to retire or leave their employer coverage. They don't have to wait for specific enrollment periods such as the Annaal Election (AEP) which runs from October 15th to December th, or the Open Enrollment (OEP) that takes place from January ist to March 31st. has been satisfied for major medical services like MRI's, CT scans, outpatient surgeries, and hospitalizations. However, plenty of folks can be on the hook for 10% to 30% of costs after the deductible, which can result in meeting one's MOOP, which represents the most out of pocket costs one can responsible for. MOOP's on many plans can be as high as $7,000. Let's use a heart bypass surgery as an example. According to a Health and Human Services peer reviewed manuscript written in 2016, the meane a bypass operation including the related We have met far too many people, mostly retired teachers, who were given as much as seven years no Cost health insurance as an early retirement incentive that took them past age 66. Not do those who didn't know better face Part B late enrollment penalties of $15 to $36/ month in addition to the standard $1.8 premium, they also can only enroll in Part B during the OEP for a July ist effective date. This can put people in a bad situation where they must wat over a yeat n for Part B to become active. In someone in this situation would either need to pay for COBRA. cost of Ihospital stay was $151,271. Even with just 10% coinsurance. anyone who had a medical service this expensive would meet their MOOP Many people who have higher which can be as much as: per month, ACA (Obamacare) plan through the Marketplace thait are also expensive and not nearly as good of r purchase a full cost However, those who work past 65 or have a spouse that works past. 65 should let myself or another of our licensed agents look at plan details and costs loer sponsored staying on an employer plan or enrolling in Medicare and a Supplement or an Advantage Plan is the better value. deductibles and/or MOOP may want to pay more for Medicare and a plan that eliminates the prospect of getting bills in the $5,000 to $7.000 range. coinsurance. coverage The Part D penalty is 1% for every month nh one poes without a plan. Many people make the mistake of not choosing Part D because they ke Jdat Lastly, because Medicare B prescription plans, both "Stand Alone" that those on Supplements need and Part D provided by Advantage Plans, are subject to the "Doeut Hole." what medications one is taking is the last factor that goes into the decision of opting out of Part B or going with Medicare. Those who fall into the Donut Hole can spend thousands more on the same medications as those on employer plans. I can recall several occasions where I was on the verge of recommending someone go on Part D The There are several factors that go into this decision. Obviously cost the first. I estimate that 25 of those we meet who get insurance through a nor penalty for enroll for th amount to about $13/month so, it's not what needs to be feared. It's the etrs would only an employer are better off anoe being diagnosed with and needing an oral chemo drug that remaining on their plan and opting out of Part B. However, some employers only cover 50% of the cost which usually makes Medicare the better cholce. It's also not uncommon for an employer ewould into like not efect u leaving them to come up with a way to pay for the medication entirely out of their own pocket. to contribute less towards the spouse's premium than they do for the employee. In many cases, we recommend the employee stay on Medicare until they told me what meds they were taking Again, those who can get insurance through an employer. own or a spouse's, cn ópt out of Part B without penalty Be advised. you can't keep a subsidized ACA plan when you're Medicare eligible! Doing so will result in one being foroed to pay back every dollar in subsidies that was received. We're talking about as much as $7000 or more. their work plan and the spouse go on Medicare. With many employers forced to offer plans with higher deductibles to offset premium increases, the amount of the deductible has also become insurance at little or no cost and have a reasonable deductible, coinsurance, and MOOP are best to do a critical factor to consider, especially for those who are higher utilisers of health care. We see more and more people who have S2.000 to $5000 deductibles, as well as plans where all medical services are subject to a deductible. These are known as HDHP's, High Deductible Health Plans that are Health Savings Account compatible. I give my employees this option and actually insure myself and my kids with an HDHP. I also don't suggest Federal retirees who can get a plan that covers them well without Part Bopt out. There are too many variables and uncertainties in the market to take that chance. I also don't recommend Veterans who exlusively use the VA for their care go without Part B, especially those in rural areas that are a good drive away from a fall-service VA hospital. If you have any questions regarding this column or any other in the "New to Medicare" series or would like to set up an appointment fora no cost consultation, please call one of our offices or reach out to me personally at aaron GetYourBestPlan.com. There are penalties for those who t have employer sponsored bealth care amd are late to enroll in both Medicare Parts Band D. According Medicare and Medicaid, "If you didn't get Part B when you're first eligible, your monthly premium may go up 10% period you could've had Part B. but didn't sign up. In most cases, you'l have to pay this you pay your premiums, for as g to the Centers for reach 12 month penalty each time Two other factors that work in conjunction with one anothe are coinsurance and the a Maximum Out of Pocket (MOOP). Coinsurance is the percentage of the remaining bill one must pay after the deductible has been met. Many, if not most employer plans pay f00% after the deductible who shouldn't opt out are those who are getting free or reduced cost health insurance from a company they retired from. You or your spouse must be Fata The Health Insurance Store. 724-603-3403 Email your question to: aaron@getyourbestplan.com Connellsville 412-349-8818 Forest Hills www.getyourbestplan.com No-cost, unbiased Medicare plan review and consultation with local, licensed agents Paid Advertisement Ask the Medicare Specialist by: Aaron Zolbrod Welcome to Part 3 of the series, "New to Medicare," which I'm writing to help guide those who will soon be going on Medicare Parts, A. B, or both. If you've missed the previous columns, you can read them on our website as well as listen or watch the podcast and webcast versions. QUESTION: I Do I have to enroll in Medicare when I turn 65 ir Im still working? Are there penalties for not doing so? Who should and shouldn't enroll in Medicare? ANSWER: It's not necessary to enroll in Part Bat age 65 when one is getting health insurance through their own or a spouse's employer And in this case, when opting out, there are no late enroliment penalties, the details of which I will explain shortly. In addition, people on employer plans can enroll in Part B during any time of the year when they decide to retire or leave their employer coverage. They don't have to wait for specific enrollment periods such as the Annaal Election (AEP) which runs from October 15th to December th, or the Open Enrollment (OEP) that takes place from January ist to March 31st. has been satisfied for major medical services like MRI's, CT scans, outpatient surgeries, and hospitalizations. However, plenty of folks can be on the hook for 10% to 30% of costs after the deductible, which can result in meeting one's MOOP, which represents the most out of pocket costs one can responsible for. MOOP's on many plans can be as high as $7,000. Let's use a heart bypass surgery as an example. According to a Health and Human Services peer reviewed manuscript written in 2016, the meane a bypass operation including the related We have met far too many people, mostly retired teachers, who were given as much as seven years no Cost health insurance as an early retirement incentive that took them past age 66. Not do those who didn't know better face Part B late enrollment penalties of $15 to $36/ month in addition to the standard $1.8 premium, they also can only enroll in Part B during the OEP for a July ist effective date. This can put people in a bad situation where they must wat over a yeat n for Part B to become active. In someone in this situation would either need to pay for COBRA. cost of Ihospital stay was $151,271. Even with just 10% coinsurance. anyone who had a medical service this expensive would meet their MOOP Many people who have higher which can be as much as: per month, ACA (Obamacare) plan through the Marketplace thait are also expensive and not nearly as good of r purchase a full cost However, those who work past 65 or have a spouse that works past. 65 should let myself or another of our licensed agents look at plan details and costs loer sponsored staying on an employer plan or enrolling in Medicare and a Supplement or an Advantage Plan is the better value. deductibles and/or MOOP may want to pay more for Medicare and a plan that eliminates the prospect of getting bills in the $5,000 to $7.000 range. coinsurance. coverage The Part D penalty is 1% for every month nh one poes without a plan. Many people make the mistake of not choosing Part D because they ke Jdat Lastly, because Medicare B prescription plans, both "Stand Alone" that those on Supplements need and Part D provided by Advantage Plans, are subject to the "Doeut Hole." what medications one is taking is the last factor that goes into the decision of opting out of Part B or going with Medicare. Those who fall into the Donut Hole can spend thousands more on the same medications as those on employer plans. I can recall several occasions where I was on the verge of recommending someone go on Part D The There are several factors that go into this decision. Obviously cost the first. I estimate that 25 of those we meet who get insurance through a nor penalty for enroll for th amount to about $13/month so, it's not what needs to be feared. It's the etrs would only an employer are better off anoe being diagnosed with and needing an oral chemo drug that remaining on their plan and opting out of Part B. However, some employers only cover 50% of the cost which usually makes Medicare the better cholce. It's also not uncommon for an employer ewould into like not efect u leaving them to come up with a way to pay for the medication entirely out of their own pocket. to contribute less towards the spouse's premium than they do for the employee. In many cases, we recommend the employee stay on Medicare until they told me what meds they were taking Again, those who can get insurance through an employer. own or a spouse's, cn ópt out of Part B without penalty Be advised. you can't keep a subsidized ACA plan when you're Medicare eligible! Doing so will result in one being foroed to pay back every dollar in subsidies that was received. We're talking about as much as $7000 or more. their work plan and the spouse go on Medicare. With many employers forced to offer plans with higher deductibles to offset premium increases, the amount of the deductible has also become insurance at little or no cost and have a reasonable deductible, coinsurance, and MOOP are best to do a critical factor to consider, especially for those who are higher utilisers of health care. We see more and more people who have S2.000 to $5000 deductibles, as well as plans where all medical services are subject to a deductible. These are known as HDHP's, High Deductible Health Plans that are Health Savings Account compatible. I give my employees this option and actually insure myself and my kids with an HDHP. I also don't suggest Federal retirees who can get a plan that covers them well without Part Bopt out. There are too many variables and uncertainties in the market to take that chance. I also don't recommend Veterans who exlusively use the VA for their care go without Part B, especially those in rural areas that are a good drive away from a fall-service VA hospital. If you have any questions regarding this column or any other in the "New to Medicare" series or would like to set up an appointment fora no cost consultation, please call one of our offices or reach out to me personally at aaron GetYourBestPlan.com. There are penalties for those who t have employer sponsored bealth care amd are late to enroll in both Medicare Parts Band D. According Medicare and Medicaid, "If you didn't get Part B when you're first eligible, your monthly premium may go up 10% period you could've had Part B. but didn't sign up. In most cases, you'l have to pay this you pay your premiums, for as g to the Centers for reach 12 month penalty each time Two other factors that work in conjunction with one anothe are coinsurance and the a Maximum Out of Pocket (MOOP). Coinsurance is the percentage of the remaining bill one must pay after the deductible has been met. Many, if not most employer plans pay f00% after the deductible who shouldn't opt out are those who are getting free or reduced cost health insurance from a company they retired from. You or your spouse must be Fata The Health Insurance Store. 724-603-3403 Email your question to: aaron@getyourbestplan.com Connellsville 412-349-8818 Forest Hills www.getyourbestplan.com No-cost, unbiased Medicare plan review and consultation with local, licensed agents