There are some cases when Enrolling in Part B of Medicare is not needed, or at least needs to be put off to a later date. Some of these reasons might be:
• I am still employed and I am covered under an employee based Health Plan through my employer
Even though you may have coverage from your employer, There are a few things you will need to understand before you decide too quickly that you do not need Part B of Medicare.
1. Does my Employer require that I take Part B? – Ask your Human Resources Dept. if Part B is required when you turn 65.
2. How much is my Employer Based Coverage costing me per month? In many cases, Medicare is LESS expensive than Employer Based Plans.
3. How does the Coverage from my Employer Based Plan compare to Medicare Coverage?
This one is VERY important. Does your current coverage have an Annual Deductible? Are there Copays at the Dr Office? Is there a Co-Insurance amount you are responsible for? Do you have to stay within a NETWORK of providers? Original Medicare with a Medicare Supplement (Medigap) is basically 100% comprehensive coverage. That means there are NO DEDUCTIBLES, NO COPAYS, NO CO-INSURANCE (No out of pocket costs) and NO NETWORKS! This is VERY important to Seniors as they age. Not worrying about the cost of a Hospital stay and being able to choose ANY provider a wonderful peace of mind. No matter when the Open Enrollment Period with your Employer Based Coverage is, Turning 65 years old is a Qualifying Event to DisEnroll in your current coverage and take Medicare as your Heath Care. So, do not confuse Retirement with Health Care. You do not have to be retired to use Medicare as your health care. Many of my clients have discovered that Medicare has MUCH MORE to offer for less money than their employer based coverage has, and taking Medicare has been the best decision they ever made.
• I am older than my spouse, I’m turning 65, and my spouse is covered under my Employer Based coverage too.
This one is a tough one. This is really the only time I recommend that Part B is not taken and put off to a later date. You don’t want to leave your spouse hanging out to dry if they are dis enrolled in your Employer Plan because you switch to Medicare. Alternative Individual Coverage can be VERY expensive, and not very comprehensive. Most of the time, in this case, you may have to wait until your spouse turns 65 for both of you to enjoy the benefits of Medicare.
1. Does my Employer require that I take Part B?
This is always the first step. Find this out before you do anything else.
2. Will my Employer Based Coverage cover my spouse without covering me?
Some do, This is important to find out.
3. Is there any coverage available to my spouse other than the Employer Based Plan they are
Does your spouse have health problems? Take medications? These are considerations when trying to find alternate coverage for a spouse if the Employer Based Coverage ends. This can be very difficult and frustrating.
The Bottom Line here is How Much am I paying now and What am I paying for?
Simply, if your Employer coverage is not as good as Medicare and not as cost effective, then you SHOULD be on Medicare instead of your Employer Based Coverage. The important step is to ASK your employer if Part B is required. If it is, then you should REALLY consider getting on Medicare and disenrollling in your Employer Based Plan, for many reasons.
Contact Brian and he will discuss the options with you.