Day: August 18, 2019

Delaying Medicare…Penalty or No Penalty?

I get many questions about whether there is a penalty if someone does not enroll in Medicare when they are first eligible at age 65.

Unfortunately, there is a tremendous amount of misinformation told to people approaching their Medicare age mainly by high-pressure Medicare sales people who either do not fully understand the complexities of Medicare or who simply will say whatever they think it takes to make a sale regardless of what is best for the person to whom they are supposedly helping.

As long as you have creditable health insurance coverage through an employer – whether it is your employer or your spouse or legal partner – you can delay going on full Medicare until the time you leave the employer coverage without incurring any penalty now or in the future.

Here are some important things to know when you are about to turn 65 or are already 65 or older and have the option to stay on your employer coverage.

2019-08-16 Charles Bradshaw
Charles Bradshaw

1) You may want to enroll in Medicare Part A only and not enroll in Medicare Part B. Medicare Part A covers you if you are an in-patient in the hospital or in a Skilled Nursing Facility for rehabilitation.

Unlike Medicare Part B, there is no monthly premium for Medicare Part A. If you go into the hospital or a Skilled Nursing Facility and still have employer coverage, there is a good chance Medicare Part A will pay for some costs for which you will otherwise be responsible.

An exception to this guidance is if you are currently contributing to a Health Savings Account (HSA). If you are contributing to an HSA you should not enroll in Medicare Part A only as you cannot contribute to an HSA once your Medicare Part A is effective.

2) Once you are 65, you have the choice of staying on your employer coverage or going on full Medicare. This is a decision you must make yourself. Your employer is prohibited by federal law from encouraging you to leave their coverage and go on full Medicare. However, it is often the right choice financially and healthwise for you to go on full Medicare.

Employer coverage or full Medicare? How to decide

3) If you choose to stay on your employer coverage past when you are eligible for Medicare, you can choose to change to full Medicare at any time. Your right to go on full Medicare at any time supersedes the election timetable your employer has for their coverage.

4) Once you decide to leave employer coverage and go on full Medicare, you will need to have your employer complete and sign form CMS-L564E – a form provided by Social Security in which your employer attests you have had credible health insurance with them and verifies when you are leaving that coverage.

You will then need to take this completed form CMS-L564E to your local Social Security office and they will enroll you in Medicare Part B (and Medicare Part A if you do not already have Medicare Part A) to coincide with when you leave your employer coverage.

5) When you first go on Medicare Part B, you will be able to enroll in any Medicare Supplement plan – including Plan G – offered in your area with no health questions because you will be in your 6-month Open Enrollment period that commences with your Medicare Part B effective date.

A Plan G Medicare Supplement, combined with Medicare Parts A and B, will allow you to go to any doctor or hospital anywhere in the country that accepts regular Medicare – as almost all do – and all of your costs will be covered 100 percent after you pay Medicare Part B’s once-a-year deductible of only $185.

You will also be able to enroll in a Medicare Part D drug plan without penalty because you will have a two-month Special Election Period due to losing the drug coverage with your employer plan.

I would appreciate the chance to help you with your Medicare transition when the time is right so you can choose the right Medicare plan for you both now and in the future.

I am also happy to help you evaluate whether your best option is to stay on employer coverage or go on full Medicare.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.

 

Why Plan G Instead Of Plan F

I often hear the following from someone going Medicare who in the past has cared or currently is caring for a parent or other family member:

“My <mother, father, aunt> had a Plan F Medicare Supplement and it covered everything and that is what I want.”

I understand that point of view completely. There is no better frame of reference for what any us of can expect with our health in the future than what we have seen or see with our parents or other older loved ones.

2019-08-16 Charles Bradshaw
Charles Bradshaw

With a Plan F Medicare Supplement, our older loved ones can go to any doctor or hospital anywhere in the country that accepts Medicare – as almost all do – and all of their costs are covered 100 percent.

My mother, who will be 98 in November, has a Plan F Medicare Supplement from AARP. When she had a full hip replacement a few years ago she did not have to pay one cent for any part of the procedure or rehabilitation. This included the three days she spent in the hospital and the six weeks she spent in a rehabilitation facility.

However, Congress passed a law in 2015 that makes a Plan F Medicare Supplement no longer the right choice for someone going on Medicare today.

The law Congress passed in 2015 begins to phase out Plan F Medicare Supplements beginning in 2020. Specifically, it says no one who becomes eligible for Medicare beginning on January 1, 2020 can enroll in a Plan F Medicare Supplement.

Anyone who currently has a Plan F Medicare Supplement at that time will be able to keep it. However, because younger people will not be able to join them in Plan F, the overall group of people who have Plan F Medicare Supplements will gradually become older and have a higher level of health issues than other Medicare Supplement plans.

For example, by 2025, everyone in a Plan F Medicare Supplement will be 70 years old or older. By 2030, everyone in a Plan F Medicare Supplement will be 75 years old or older.

By comparison, at both of these points in time other Medicare Supplements such as Plan G will have people who are 65 years old and older.

The younger overall mix in other Medicare Supplements such as Plan G will mean the average health care costs per person, and therefore monthly premiums, will be less in other Medicare Supplements than in Plan F.

This will cause premiums for people with Plan F to increase at a much higher rate in the future than other Medicare Supplement plans.

An excellent alternative to Plan F that will not increase in premiums as much because of the change in the law is Plan G. A Plan G Medicare Supplement provides the exact same coverage as Plan F except the policyholder pays Medicare’s once-a-year Part B deductible which is $185 in 2019.

Because Plan G’s premiums are usually at least $40 per month less than Plan F, the savings one receives in the lower monthly premium over 12 months with Plan G more than pays for the once-a-year $185 Part B deductible.

Very importantly, Plan G is the only Medicare Supplement other than Plan F that covers Medicare Part B Excess charges. Medicare Part B Excess charges are the up to 15 percent extra some medical providers charge for people with Medicare.

Because of this, I recommend Plan G instead of Plan F for anyone now going on Medicare. In addition, I strongly recommend anyone who currently has a Plan F Medicare Supplement who can switch to Plan G do so.

You do not have to wait until Medicare’s Annual Enrollment Period in October to change Medicare Supplements. You can change Medicare Supplements at any time during the year though if you have been on Medicare more than 6 months your ability to change will depend on your health situation.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.

 

Getting Diet Advice From McDonald’s

A gentleman named Edward from Nashville scheduled a Medicare consultation with me that took place yesterday.

When I called Edward, I could tell right away he was stressed out about the fact he was turning 65 in a few months and going on Medicare. He told me he was getting bombarded with all kinds of mail and phone calls about Medicare and was having a hard time keeping up.

I told him to take every piece of mail he had received about Medicare from anyone except the government and put it in the nearest recycle bin. I also told him to stop taking calls from anyone he did not know.

2019-08-16 Charles Bradshaw
Charles Bradshaw

Nearly 100 percent of the mail or phone calls you receive about Medicare when you are about to turn 65 is from a company wanting to make a lot of money off of your hard-earned Medicare benefits.

These companies such as Humana and Kaiser Permanente are not trying to help you learn how Medicare works and what your options are with Medicare. They are mainly trying to steer you toward their private, for-profit, restricted-choice Medicare Advantage plans that can be catastrophically bad for both your health and finances.

They are literally attempting to get you to permanently sign over your Medicare benefits so they can divert your Medicare dollars away from spending on your health and to their profits.

Trying to learn what you need to know about Medicare from Humana is the same as getting diet advice from McDonald’s.

When you sign over your Medicare benefits to a private, for-profit Medicare Advantage Plan such as Humana Gold Plus, you are giving Humana full control over your health care. Humana will make decisions about the health care you receive and the doctors you can see based on the cost rather than what gives you the best chance for the best health outcome.

The less Humana spends on your health care the more money they make as a company and the higher salaries and bigger bonuses they can pay to themselves.

When you are approaching the time you first go on Medicare, it is critical that you learn how Medicare works from an unbiased source. You need to fully know and understand your Medicare options so you can make the right decision for you both now and in the future.

I started MedicareAnswerCenter to help as many people as possible fully understand their options with Medicare so they can make the right decisions for them. We do not enroll anyone in any Medicare plan until we know they fully understand their options and have decided on a Medicare plan based on what is right for them.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.

What about Plan N?

One Medicare Supplement option that can be a good choice for some people is a Plan N Medicare Supplement.

With a Plan N Medicare Supplement, the person on Medicare pays a lower monthly premium in return for paying Medicare’s Part B annual deductible as well as some co-pays and other costs throughout the year.

A Plan N Medicare Supplement is typically around $15 to $20 per month less than the Plan G Medicare Supplement I usually recommend.

In return for the lower monthly premium, the Medicare member pays the following out-of-pocket costs:

2019-08-16 Charles Bradshaw
Charles Bradshaw

1) Medicare’s annual, once-a-year Part B deductible which in 2019 is $185. The policyholder also pays this deductible with Plan G.

2) A $20 co-pay for a doctor visit for either a primary care doctor or a specialist. The policyholder would not pay this co-pay with Plan G.

3) A $50 co-pay for an Emergency Room visit that does not lead to a hospital in-patient stay. The policyholder would not pay this co-pay with Plan G.

4) A potential 15 percent surcharge on Medicare Part B costs when the policyholder uses a medical provider that has opted out of Medicare’s regular fee structure so they can charge an extra 15 percent for Medicare patients. This extra 15 percent is called Medicare Part B Excess.

Category #4 is the real drawback when considering a Plan N Medicare Supplement. A Plan G Medicare Supplement pays the Medicare Part B Excess while Plan N does not.

As you probably can guess, the doctors and medical facilities that charge Medicare Part B Excess tend to be ones in high demand. Mayo Clinic is an example of a medical provider that charges Medicare Part B Excess.

This means if you ever have a serious health issue and want to make sure you are receiving care from the best doctor for your condition, you may have to choose between the doctor you think is best but for whom you will pay an extra 15 percent out of your pocket or a doctor who does not charge the Medicare Part B Excess.

While 15 percent of the cost of a doctor visit may not seem like a significant cost, keep in mind this can apply to expensive medical procedures and treatments such as MRIs and chemotherapy. In these cases 15 percent of the cost can be significant and can be hundreds or even thousands of dollars.

I prefer Plan G because I want you to be able to receive care from whatever health care provider you believe is right for you without worrying about the costs.

However, paying a lower monthly premium is necessary for many people and choosing a Plan N Medicare Supplement is a much better option than leaving Medicare and enrolling in a for-profit, private Medicare Advantage plan where your access to care is limited and costs can be much higher.

At Medicare Answer Center we appreciate the privilege of assisting you with learning about your Medicare options so you can make the right permanent Medicare decision.

Simply click the following link to schedule a free, no-obligation 30-minute Medicare consultation.

Click here to schedule your free, no-obligation Medicare consultation

Click here to message us via Facebook Messenger

Click here to request a quote for your Medicare Supplement from Medicare Answer Center

Click here to immediately download – Ten Most Asked Questions By People Going On Medicare

You can also call me at (865) 851-1120 or email me at charlesbradshaw@medicareanswercenter.com.

I look forward to talking with you soon.

Charles Bradshaw is President and Founder of MedicareAnswerCenter.com.