I often hear from clients that this Medicare process is so confusing. I get it; I’ve been at it for over 15 years, and the federal level always throws a wrench into the mix. But don’t worry, Senior Legacy Partners is here to help simplify the process and make the transition to Medicare as easy as possible. Here are some reminders and a checklist as you prepare.
Do You Still Plan on Working?
If you plan to work past 65, which is more common these days, check a few things. Does your work coverage meet creditable coverage standards? The insurance carrier or your work HR department should be able to answer this. Should I stay on work coverage? That depends on a few factors; Senior Legacy Partners can help you wade through them. If I keep work coverage, will I be penalized? You will not be penalized if your coverage meets creditable coverage standards. You can enroll in Part A if you would like, but if you use an HSA (Health Savings Account), you must stop contributing if you enroll in Part A.
What Will Medicare Cost Me?
Medicare Part B has a standard premium that CMS sets every year. Typically, the numbers for the upcoming year come out in the fall. However, if your income is above certain thresholds, you will be required to pay IRMAA (Income-Related Medicare Adjustment Amount). IRMAA is the aunt no one wants to visit — CMS will charge you a surcharge on top of your standard premium. There are ways to mitigate this issue; talk to Senior Legacy Partners.
What Parts of Medicare Do I Need?
Medicare has four main parts: Part A, Part B, Part C, and Part D. If you are enrolling in Medicare, Parts A and B are essentially mandatory for most. Part C is Medicare Advantage, and if you choose that coverage path, you will enroll in it; it also includes Part D in most situations. Part D is prescription drug coverage. Some choose to do Medicare Supplement, but those are not “parts” of Medicare.
How Do I Enroll in Medicare?
Medicare enrollment is confusing. You can enroll through the Social Security office. You can enroll through ssa.gov or call your local office. This process only starts with Parts A and B. Senior Legacy Partners can help figure out your coverage options from there.
When Do I Enroll in Medicare?
If you are turning 65 and planning on enrolling in Medicare, you can do so during your IEP (Initial Enrollment Period). Your IEP starts 3 months before the month you turn 65, includes the month you turn 65, and runs for 3 months after, for a 7-month period. Applying for Medicare Parts A and B during this window will avoid any late enrollment penalties. Additionally, Medicare Supplement coverage has its own initial enrollment period, which you can find here: Medicare Supplement FAQs.
Will My Doctors Take Medicare?
Most doctors and hospitals nationwide (up to 96%) take Original Medicare. If you choose a Medicare Advantage plan, make sure the doctor is in-network with that plan, not just with Medicare. If your Medicare Advantage plan doesn’t cover your doctor, you’ll need to find a new plan or a new doctor.
Do You Know What Work Benefits Are Available and How They Compare?
Workplace retiree benefits are becoming less frequent nowadays. Retiree health and pension plans still exist. Do you have retiree health and pension through work? How does it compare to what is available to you on the open market? Senior Legacy Partners can help you run the analysis to see which option is right for you.
What Is Not Covered Under Medicare?
While Medicare covers most medical needs, it doesn’t cover some areas. These include dental care, eyeglasses, over-the-counter medications, and long-term care. Medicare Advantage offers some basic coverage for dental, eyes, and over-the-counter meds, but it’s limited, and providers who accept the plan are limited. Long-term care is a big issue most advisors either ignore because it’s hard to solve or “self-fund” because it is in the advisor’s best interest. Senior Legacy Partners takes an in-depth, independent look at your long-term care risks to see what planning solutions are appropriate.
This list isn’t comprehensive, but it covers the main items on the checklist to keep in mind as you head into Medicare. No single solution or program is a one-size-fits-all silver bullet. That’s why a zero-obligation consultation with Senior Legacy Partners is a valuable first step. We will take a comprehensive and independent look at your healthcare needs and coverage fit.