Category Archives: Special Enrollment Period

Leaving Employer Insurance For Medicare

Get Prepared for Part B

It is time to think about leaving your employer insurance for Medicare and to Apply for Medicare Part B.  The purpose of this article is to help you prepare for Medicare, in advance, Losing Sutter Medicare: Returning from Medicare Advantage to Traditional Medicareand to avoid missing important deadlines, which could lead to missed opportunities or even extra costs.  Bookmark this story or share it with a friend.

CHECKLIST: Leaving Employer Insurance and Transitioning to Medicare From Employer Health Insurance

  1. First, if you are currently working and receiving employer-sponsored health insurance, do not sign up for Medicare Part B solely because you turned 65.  Read our related article to Understand what you are getting into.  While there are some exceptions, if you work for a large employer (20 or more employees), you don’t need to do this yet.
  2. Second, those employer plan disclosures e.g. Annual Notice of Creditable Coverage for prescriptions? Don’t throw them away if you are Age 65 or older.  This could cost you extra money.  My advice is to start a Medicare Preparedness File, and save this article as part of your checklist.
  3. Third, have a discussion with your primary care physician:  Ask if they currently accept new patients, especially those on traditional Medicare.  Be bold, and ask if they plan to retire in the near future.  It’s better to find out sooner than later if you need to research a new primary care physician.
  4. Fourth, find an independent agent who focuses on Medicare health plans…and I mean lots
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    of plans e.g FAQs on various Plan Gs.  You are going to need their ongoing, independent advice, as plans (and Medicare) do change over time.  Plus, you need help initially, to discuss a transition plan for leaving employer insurance for Medicare Part A and/or Part B and possibly coordinating temporary COBRA coverage for you and/or a spouse .  Finally, get independent feedback on all the medigap plans and different “flavors of G.”  We put together a good introduction to this topic.  Read:  The Buzz About Plan G and Plan G Extra.

“Our insurance agency is local, and fiercely independent, and contracted with 37 different insurance companies.”

It Is Foolish Not To Use A Local, Independent Agent

Californians do not receive a premium discount when you bypass an agent to go directly to

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the insurer; you only lose your “independence.”  Once you understand this, it is in your best interest to find an experienced, independent agent  to help your transition from employer-sponsored plans to the Medicare world (It’s better than waiting on hold for two hours with Social Security).

A more detailed article on these issues and important timelines and deadlines can be found on our website, derendingerins.com.

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“We do not offer every plan available in your area.  Any information we provide is limited to those plans we do offer in your area.  Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.”

Timelines and Deadlines of Medicare Part B

Applying for Medigap Insurance is easy, but understanding the timelines and deadlines of Medicare Part B is critical, and will be the focus of the remainder of this article.  Insurers will not issue you Medigap (Medicare Supplement) Insurance until you are enrolled in Medicare Parts A and Part B. However, many will accept your application early and pend it, while your Medicare application is being processed.

Timelines and deadlines of Medicare Part B

The official U.S. Government Handbook on Medicare is called Medicare and You. Another valuable government publication is Choosing a Medigap Policy.  These combine for 128 pages of valuable information.  Yes, it’s a lot of pages, and if you want the readers digest version, ask for help:  Connect with an independent agent in west San Jose- it’s FREE and will save you hours of time: (408) 252-7300.  The links to publications are at the bottom of this article, and the following are some important excerpts:

Timelines and Deadlines of Medicare Part B:  Initial Enrollment Period

I encourage everyone to get a local consultation e.g. Silicon Valley/Bay Area by age 62, in order to understand “what you are getting into.”  But once you reach your Initial Enrollment Period or IEP, you can first sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you sign up for Part A and/or Part B during the first 3 months

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of your Initial Enrollment Period, in most cases, your coverage starts the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month. If you enroll in Part A (that you have to pay for) and/or Part B the month you turn 65 or during the last 3 months of your Initial Enrollment Period, the start date for your Part B coverage will be delayed. 

“Remember, in most cases, if you don’t sign up for Part A (if you have to buy it) and Part B when you’re first eligible, you may have to pay a late enrollment penalty.”

Still need help?  Then get an independent agent– Did you know there is no extra cost for these services?  They are compensated by your Medigap insurance company and you will pay the same low premium with or without an agent.

Timelines and Deadlines of Medicare Part B:  General Enrollment Period 

If you didn’t sign up for Part A (if you have to buy it) and/or Part B (for which you must pay premiums) during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can sign up between January 1–March 31 each year. If you enroll using this SEP, Your coverage won’t start until July 1 of that year, and you may have to pay a higher Part A and/or Part B premium for late enrollment.

What’s the Part B Late Enrollment Penalty? 

If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12 months in the period that you could’ve had Part B, but didn’t sign up for it. If you’re allowed to sign up for Part B during a Special Enrollment Period, you usually don’t pay a late enrollment penalty. See page 17

Still need help?  Then get an independent agent– there is no extra cost for these services.

In California, many of us work past Age 65, how does that affect timelines and deadlines?

If you didn’t sign up for Part B when you were first eligible because you’re covered under a group health plan based on current employment, then you can sign up for Part B anytime while you’re still covered by a current employer group medical plan.  You also may sign up for Part B during the 8-month period, immediately after employment or coverage ends (the period begins based on whichever occurs first). This is referred to as a Special Enrollment Period.  

If you are working past 65, and thinking about transitioning off employer health insurance,  we have prepared a checklist to help you, but read this first.

There are other Special Enrollment Periods, in certain situations. Get an independent agent to guide you at no extra cost or phone Medicare directly at 1‑800‑MEDICARE (1‑800‑633‑4227).

Resources and Links

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