I recently had a mechanical engineer who builds bridges in my office. After we discussed Medicare he said, “I build bridges and I STILL don’t understand this stuff.”
Medicare is not one of the easiest concepts to grasp. Although the government has a website (www.medicare.gov), volunteers with SHIIP (Senior Health Insurance Information Program) and printed guides (Medicare and You Handbook 2018) it is still quite confusing. In this article, I am going to explain the different Enrollment Periods and how they affect individuals.
INITIAL ENROLLMENT PERIOD
This is the three months before turning 65, the month of your birth and the three months after. This is the first time individuals are Medicare eligible, therefore everyone receives the preferred, non tobacco rate for supplemental coverage. There are three basic scenarios I see around the initial enrollment period.
- The person eligible has individual health insurance (not through an employer) – most often they should enroll in Medicare Parts A/B and find supplemental products because the individual coverage may not be available after turning 65
- The person eligible has employer coverage as an active (working) employee or they are covered by an actively working spouse. This situation may take some calculating to compare premiums and estimate costs determining which option is most cost effective.
- The person eligible is actively working or has coverage through an actively working spouse and the benefit design is a high deductible health plan with a health savings account. STOP!! We should talk to see if you would like to continue to contribute to the HSA or not.
SPECIAL ENROLLMENT PERIOD
This is a date chosen by individuals who have remained on creditable (of value) health coverage through their own active employment or the active employment of their spouse. Medicare hasn’t been keeping track of what coverage the eligible person has had. Due to this, there are forms that need to be filled out and turned into Social Security before being able to enroll in Medicare supplemental products.
If you don’t remember anything from this article remember this…. 90 DAYS… 90 days before tuning 65 or 90 days before leaving active employment give me a call and we can discuss the options and find the one that best fits your needs and your comfort.
A little more about us:
The Business Warrior group has some of the industry’s top experts in all the areas your business needs to be successful. Amongst the contributors is Janis VanAhn, owner of Health Insurance Advisor, LLC. For 19 years Janis has worked in and around the health insurance industry initially providing service to agents and employers related to employee benefits, individual healthcare and Medicare, while more recently becoming appointed as an individual agent with various quality carriers to provide this service to individuals through her own business.
Four years ago Janis was ‘blessed’ with being let go from her job at an insurance ageny. Staying within insurance was her path…but in what capacity. 2010 was the year Janis began her career as an independent insurance agent specializing in health insurance. Finding quality, cost-effective healthcare for individuals and families under age 65 as well as working with those who are Medicare eligible truly was her passion. She has made this a true specialty and positioned herself as someone to work with whether it is a financial professional or property & casualty agent with a client that needs assistance, to a group of seniors turning 65 and they keep receiving Medicare information and are confused about what to do.
Janis enjoys the one on one contact with clients as well as looking forward to speaking to groups about healthcare. Her excitement for this industry is what drives her to stay in tune with Healthcare Reform and what is currently happening and what will happen with coverage from now to past 2014.
‘Educating individual and Medicare consumers to make informed choices’ is her mission because if people are educated and understand, they will make informed choices that they are comfortable with.