Episode Transcript
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Speaker 1 (00:01):
Welcome to Medicare three sixty, where the world of Medicare
is simplified and you are empowered to make informed healthcare choices.
With over two decades of experience and insurance and financial solutions.
With host licensed insurance Agents Jennifer Lee, you are guided
through the ins and outs of Medicare, whether you are
(00:22):
nearing retirement, navigating your options, or just curious about what's available.
Everything you need to know is covered. Tune in for
knowledgeable insights, tips and answers to your Medicare questions so
you can take charge of your health and your future.
And Now Medicare three.
Speaker 2 (00:40):
Sixty Welcome to today's Medicare three sixty radio show. I'm your host,
Jennifer Fonso Lee, certified long term care Specialist, investment Advisor,
representative and founder of Premier three to sixty Insurance Financial Solutions.
(01:02):
Today's show is one of the most requested topics I
get in my office and one of the most misunderstood.
How to apply for Medicare at sixty five, what to
do if you're retiring after sixty five, and the mistakes
that can cost you penalties for life if you or
your spouse are approaching sixty five, working past sixty five,
(01:27):
or thinking about retiring the next few years. This episode
is for you, grab a pen. This information can save
you thousands of dollars and years of frustration. So understanding
basics before you apply. Before you apply, you need to
(01:47):
understand the building blocks of Medicare, which is original Medicare,
Part A hospital, Part B medical like your doctor visits
outpatient care, and the optional coverage of Part D prescription drugs,
Medicare supplement, which is medicap Medicare advantage, which is also
(02:09):
Part C A hospital B medical D drugs usually equals Part.
Speaker 3 (02:17):
C, which is Medicare advantage.
Speaker 2 (02:20):
Biggest misconception is Medicare is not automatic for most people.
If you don't apply correctly, you could miscoverage, pay penalties,
delay retirement, lose employer coverage incorrectly.
Speaker 3 (02:36):
So those are the things you have to make sure.
Speaker 2 (02:41):
So applying for Medicare when turning sixty five, you have
your initial enrollment period. You have three months before your
sixty fifth birthday and then includes your birthday month and
three months after your birthday, which becomes a three sorry
a seven month window. So those are three months before,
(03:07):
three months after, but that doesn't necessarily mean that the
month that you apply you'll get it, So meaning if
you apply three months before your birthday, it will be
issued effective your birthday month, not the birthday of your birthday,
but the first day of the month of your birthday.
(03:31):
If you do apply three months after your birthday, depending
on the month, it will be effective the following month. Okay, So,
if you're the lucky for you that are already receiving
Social Security, you're automatically enrolled and Part A and Part
B your medicare arrives by mail and you don't have
(03:54):
to worry about applying like the rest of us. Right, So,
you could decline if you're still working. So in the
back of the card there is instructions that basically state
how to decline that if you are still working, if
you're not receiving Social Security, then you must actively apply
(04:17):
online at SSA dot gov, by phone with Social Security,
or in person at SSA. But I would say online
is the easiest way. By phone, you set up an appointment,
depending you don't have to go to your local SSA office,
(04:41):
especially when they want you to make an appointment before
you come as well, So online it does get a
little bit rigorous because if you've never set up your
SSA dot gov account, you do have to set that
up by either or how can I, jeez, I do
(05:03):
this every single day for clients, So you would actually
have to have an email address and like a cell
phone or a number to verify. It is rigorous because
you create, you put your email in there, then they
(05:25):
ask you to send that email and then they will
ask you to put in your password. Then it will
generate another text and then asks you more questions. So
(05:46):
it is a rigorous process. And at the end it
will ask you to take a picture of your driver's license,
run our back or your ID, and to show your
face on your cell phone. So you really do need
to have a cell phone, okay. So then if for
(06:06):
some reason you are not able to verify like your
face or your driver's license, you'll have to go to
your local post office to get that verification to get online.
Speaker 3 (06:21):
It is a very rigorous process. So we help you
with that. No problem on that, okay.
Speaker 2 (06:29):
So what happens if you apply late? Of course, there
are coverage delays, there's late improllment penalties, and there's gaps
in healthcare. So Part A only versus Part A and B.
So this is like the biggest thing because some people
only take Part A at sixty five. But this is
(06:51):
where the mistake happens. Okay, you should only delay Part
B if you have credible employer coverage from an active
employment through an employer with twenty plus employees. Okay, because
credible coverage exempts you from that ten percent penalty that
(07:17):
you would receive by not being on Medicare at sixty five. So,
if you are on a individual plan Obamacare ACA subsidized
and cover in California, it's called Covered California, you do
need to get Medicare Part A and B.
Speaker 3 (07:42):
Okay.
Speaker 2 (07:43):
If you are working and you still have group insurance,
then that is credible. So you really don't need Part
A or Part A and B, right, if you're going
to keep your group insurance. However, some people do want
(08:03):
Part A because it supplements the hospital portion. And the
biggest thing is, do not get Part A if you
have a health savings account that you are contributing to,
because if you are contributing to health savings account, you
just can't get You shouldn't get Part A. Okay, if
(08:26):
you are working with an employer less than twenty employees,
you do have to get Medicare Part A and.
Speaker 3 (08:33):
B because why because because.
Speaker 2 (08:41):
Gosh I lost my family thought, because any plan that
is less than twenty employees is not credible coverage. Okay,
So working past sixty five, how Medicare works with employer ridge? Okay,
(09:02):
it's really confusing, right, So, large employer twelve plus employees,
employer insurance pays first. MECAN Medicare is secondary, and you
could delay Part B without penalty. So if you are
paying for your group insurance, you do not have to
(09:24):
get Part B, which you pay for, right, Like, don't
double ensure yourself and waste money by having two Okay,
Small employer under twenty employees, Medicare pace first. That's why
you do need to enroll in Part B A and
(09:45):
B at sixty five, and an employer coverage pays second.
Speaker 3 (09:50):
Okay, Okay.
Speaker 2 (09:53):
Another big question I always get is spouse's employer coverage
rules still apply based on employer size. Okay, So large employer, Okay,
you have credible coverage. You do not need to get
Part A and B. You can get Part A if
(10:13):
you don't have a health savings account, but less than
twenty employees, you will have to get coverage. So the
biggest thing on that is I typically compare your group
coverage to Medicare to see which would provide you the
(10:35):
most benefits, the lowest amount of premiums, or whatever you
would like. Right, So it's a comparison because sometimes it's
pretty straightforward. My employer plan is wonderful, I don't pay anything, right,
stay on there. But if your employer plan is not
(10:57):
that great, you're paying an arm and a leg, then
it might warrant you a comparison.
Speaker 3 (11:04):
If Medicare is better for you. Okay, So what.
Speaker 2 (11:08):
Is credible coverage? Not all employer plans qualify, so keep
that in mind. You have to be an active employee ployed.
I had this once happen right when a client was like, no, Jennifer,
(11:29):
I have I'm retired. But it is credible coverage because
they're paying for it. But once they wanted to get
on Medicare, there is a form that that employer has
to complete that basically stays how long they've had credible
coverage and active Right, So let's just say, for an example,
(11:54):
you turned sixty five, you decided to stay at work,
your group plan was pretty decent, so you stayed on
there and then let's just say at sixty seven you
decide to retire. So at that point you have to
provide the cms L five sixty form form to your
(12:17):
HR department, so they complete that and sign off that
you've had credible coverage from age sixty five to sixty seven,
so you are not penalized that ten percent every single year. Right,
So take for instance, a person didn't get that, then
they would have would be penalized twenty percent. You know,
(12:40):
two times ten twenty percent for their entire lifetime. Might
not be much for someone, but why get penalized if
you don't have to? Okay, So, like some common things
that I've seen on this as the one that I mentioned, right,
they were not active employee employed and it was they
(13:03):
got doubl eding because it was wife and husband. So
keep in mind, even if that employer is paying for
your health insurance, you might have to pay penalties because
you did not get on medicare. Right if they don't
sign that form that you've been working there since you're
since like that time, right, that you didn't have coverage
(13:26):
or had coverage with them, that that's a big thing.
I've also seen delays big companies. Guys, big companies put
the wrong date of employment and then going back and forth.
Then you might be penalized with that too, unfortunately, So
(13:49):
be very careful and mindful that your employer, you know,
will still be in business or you're going to find
someone that the HR to fill that form out right.
Most employers know about this form. You know, you're not
the only one that's retired or wanted Medicare, but you
(14:09):
know some may not. So just cognizant that in order
to avoid the penalty, they need to make sure that
it shows how long you had.
Speaker 3 (14:20):
That credible coverage.
Speaker 2 (14:23):
Okay, so not to harp again, but the Health savings warning.
Once you enroll in Medicare, you must stop contributing to
an HSA and Medicare backdates Part A up to six months.
So this mistake alone causes major tax issues. So okay,
(14:44):
let's back up because this is a little bit confusing. Okay,
so let's just say you did not apply for Part
A or Part B at sixty five. You keep work,
but let's just say you want to retire at sixty seven.
(15:06):
So when you apply for Part A and B, the
B will be effective when you want it to be, right,
like the month after you retire, right, or you don't
have coverage the Part A they backdated six months before
your part be effective date. So please keep that in mind. Right,
(15:28):
because if you're contributing to a health savings account, stop.
Speaker 3 (15:36):
Six months before you retire.
Speaker 2 (15:39):
I know sometimes you're not going to know, but just
keep that in mind because like on paper, when I
tell clients it's okay because you could just backtrack and remove.
Speaker 3 (15:51):
It from your taxes.
Speaker 2 (15:53):
But clients have told me that it has caused many
tax issues for them, right, Like really good clients that
are just they know and they're very savvy when it
comes to this, have told me it's it's a nightmare
and like it just I guess it's in a paint
(16:14):
and a butt right to bat track and figure all
that out.
Speaker 3 (16:18):
So keep that in mind as well.
Speaker 2 (16:21):
Okay, So how about when you're retiring after sixty five?
What's the steps to do for that?
Speaker 3 (16:30):
Okay?
Speaker 2 (16:30):
This is where the penalties happen most often. Your special
enrollment SEP Okay. You do have eight months after enrollment
ends to enroll in a part and part B okay,
but only two months after that to choose a Medicare
advantage or Part D plan. But the biggest thing is,
(16:51):
like I've seen this in and I've seen where people
still get penalized.
Speaker 3 (16:59):
And why wait eight.
Speaker 2 (17:00):
Months to enroll in Part B?
Speaker 3 (17:03):
Right?
Speaker 2 (17:03):
I know sometimes people have Cobra. Sometimes Cobra is still
more expensive, right I would I just wouldn't chance it
from like the issues I've seen, right, But technically eight
months after employment and that's when you could enroll, Okay,
So the critical forms is going to be the CMS
(17:24):
forty B enroll in Part B, and then the CMS
al five sixty four employer coverage verification. Okay, if I
have time, we could break that down.
Speaker 3 (17:35):
Okay.
Speaker 2 (17:36):
So common retire mistakes is waiting to long to apply, right,
And I just didn't get around to it. Cobra is
not credible credible for Medicare. So remember that I met
someone who waited one year because they were on Cobra
to get on Medicare. And she actually called Medicare and
(17:58):
asked them, is Cobra credible coverage? And they said yes,
And guess what happened? She got penalized and it took
her one year to rectify the situation. I mean, the
penalty probably wasn't as bad, but the aggravation of calling
and calling for hours on end, calling her constituents like congresspeople,
(18:23):
and it's just stressful. I probably would have just gave up. Right,
So COBRA is not credible, remember that, Okay, assuming HR
handled enrollment, human resources not. I've only had one time
which human Resources said, oh, we'll send it up to
Social Security. Don't leave it to chance. Right, We send
(18:47):
it up for clients. We do not want to leave
it to chance. Right, who knows if HR did it,
So I wouldn't leave that to a chance.
Speaker 3 (18:55):
Okay.
Speaker 2 (18:56):
Missing drug coverage deadline. Hey, when you get your Part
A hospital, Part B medical, there's an invisible drug plan there, right,
And some people were like, I don't take drugs, I
don't need a drug plan, but you have to get
a drug plan to avoid that one percent penalty. Okay,
(19:16):
So keep that in mind. So drug penalties one percent
every month that you were not on a drug plan. Okay,
added for life, which is horrible, applies even if you
don't take medications. Now, like I mentioned, okay, so choosing
(19:38):
coverage after your enroll So now what right you got
all through this.
Speaker 3 (19:44):
Congratulations.
Speaker 2 (19:46):
The Option one is original Medicare plus a medicapp plus
apart d Okay. This is the freedom to choose doctors,
freedom to go anywhere in the United States and go
anywhere that accepts Medicare, which is probably ninety nine percent
of the time. Okay. These are higher monthly premiums because
(20:07):
on top of paying your part B premium, you do
have an additional premium to pay this insurance company lower
out of pocket costs. So it's fixed because you know
exactly how much you're paying and you're deductible every year.
Speaker 3 (20:20):
It's okay.
Speaker 2 (20:22):
So Option two Medicare advantage lower premiums or even at
zero or money back. There are network restrictions, right, you have.
Most of them are HMOs. You have one doctor that
refers you to all your specialists. Sometimes there are PPO options, right,
but they're limited. They're starting to be limited, okay, prior
(20:43):
authorizations and there is maximum out of pockets depending on
the county.
Speaker 3 (20:48):
Or state you're in. You could go solo.
Speaker 2 (20:52):
There's some that are slow as one ninety nine, and
there's some higher right. So who should be careful with
advantage plans? If you're a snowbird and you're in New
York and you travel to Florida in the summers, right,
that might be a bad thing if you have multiple specialists,
(21:14):
just chronic conditions, you just prefer doctors outside of network,
or just want to go to different medical groups. That's
the disadvantage of advantage plans.
Speaker 3 (21:28):
And then there are.
Speaker 2 (21:29):
Disadvantages on metigap right the premiums. And then when you
travel overseas it's it's less coverage too. But that's probably
another topic that we will go over. Okay, So top
pip falls that costs people thousands. Okay. Mistake number one,
assuming Medicare is automatic. It's only automatic if you've been
(21:51):
on Social SSDI disability for two or more years. And
if you are getting Social Security now taking advice from
coworkers or friends. Everyone's situation is different, Okay, so keep
that in mind. Mistake number three delaying part B incorrectly
(22:13):
right if you're not an active employee, if you don't
have credibook coverage, that's a big one. Mistake number four
not understanding employer size rules. Keep in mind twenty plus
large employee credible coverage, twenty or less not credible coverage.
You need to get on Medicare. Mistake number five missing
(22:34):
Part D enrollment.
Speaker 3 (22:35):
So Part D.
Speaker 2 (22:37):
Even if you're not taking prescription drugs, now, just get
a really cheap one. Most Medicare advantage has it, so
definitely look into that. Mistake number six not reviewing plans annually.
Sometimes there's terminations, sometimes your formula, your plan changes. The
(22:58):
cost could skyrocket, right, so keep that in mind. Mistake
number seven is not planning for long term care. Many
think Medicare is going to cover it.
Speaker 3 (23:09):
It's not.
Speaker 2 (23:09):
The extended care after the skilled nursing of one hundred
days is on you.
Speaker 3 (23:15):
Right.
Speaker 2 (23:17):
If you are on Medicaid, there might be some options
for you. Some plans have a little bit of extended care,
but not all, so keep that in mind.
Speaker 3 (23:26):
Okay, So.
Speaker 2 (23:30):
Just pro tips because I do this every single day.
Apply early and not late. Okay, you just don't want
to be stressed. I've had clients where we submitted it
and it takes months to get the Part A and B. Okay,
get everything in writing of course, verify your employer size,
(23:50):
track your deadlines, review coverage annually. Work with a licensed
Medicare professional independent license agent. So I didn't have time
to go on the LMS L five sixty four and
the CMS forty B, so that's probably something I definitely
(24:13):
want to go over. Want to go over the IRMA
rates next week as well.
Speaker 3 (24:21):
So yes, I think I'm really passionate about kids. Do
it every day.
Speaker 2 (24:24):
Clients could do like an hour, and I could do
it in twenty minutes for you.
Speaker 3 (24:28):
Okay, okay, So.
Speaker 2 (24:30):
If you're turning sixty five, retiring after sixty five, or
helping a spouse or parent through Medicare, you don't have
to do this alone. At Premiere three sixty Insurance and
Financial Solutions, we do help people apply for Medicare correctly,
avoid lifetime penalties, coordinate employer coverage, choose the right plan,
(24:54):
and prepare for your healthcare costs and retirement.
Speaker 3 (24:58):
Right. I know you're probably chat GPT.
Speaker 2 (25:01):
Now all this information, but with just a guided professional
who has licensed and certified every single year to guide seniors.
Speaker 3 (25:14):
Or Medicare eligibles, we just we know the.
Speaker 2 (25:18):
Ins and outs, and I know everyone wants to do
things themselves now, but for no cost, why not have
that extended.
Speaker 3 (25:26):
Help for you? So good, easier stress.
Speaker 2 (25:32):
So thank you once again for tuning in my name
is Jennifer Alfonso Lee, your Medicare three sixty radio show hosts.
You have a wonderful Daybee.
Speaker 1 (25:44):
Thank you for joining the program Medicare at three sixty.
Hope you found today's episode insightful and empowering. Remember understanding
your Medicare options is key to making the right choices
for your health and financial well being. If you have
questions or topics you would like covered in future episodes
of Medicare three sixty, don't hesitate to reach out and
(26:07):
speak with our licensed insurance agent. Until next time, stay
informed and take charge of your health care journey. This
has been Medicare three sixty, your trusted source for all
things Medicare. Take care
Welcome to Medicare three sixty, where the world of Medicare
is simplified and you are empowered to make informed healthcare choices.
With over two decades of experience and insurance and financial solutions.
With host licensed insurance Agents Jennifer Lee, you are guided
through the ins and outs of Medicare, whether you are
(00:22):
nearing retirement, navigating your options, or just curious about what's available.
Everything you need to know is covered. Tune in for
knowledgeable insights, tips and answers to your Medicare questions so
you can take charge of your health and your future.
And Now Medicare three.
Speaker 2 (00:40):
Sixty Welcome to today's Medicare three sixty radio show. I'm your host,
Jennifer Fonso Lee, certified long term care Specialist, investment Advisor,
representative and founder of Premier three to sixty Insurance Financial Solutions.
(01:02):
Today's show is one of the most requested topics I
get in my office and one of the most misunderstood.
How to apply for Medicare at sixty five, what to
do if you're retiring after sixty five, and the mistakes
that can cost you penalties for life if you or
your spouse are approaching sixty five, working past sixty five,
(01:27):
or thinking about retiring the next few years. This episode
is for you, grab a pen. This information can save
you thousands of dollars and years of frustration. So understanding
basics before you apply. Before you apply, you need to
(01:47):
understand the building blocks of Medicare, which is original Medicare,
Part A hospital, Part B medical like your doctor visits
outpatient care, and the optional coverage of Part D prescription drugs,
Medicare supplement, which is medicap Medicare advantage, which is also
(02:09):
Part C A hospital B medical D drugs usually equals Part.
Speaker 3 (02:17):
C, which is Medicare advantage.
Speaker 2 (02:20):
Biggest misconception is Medicare is not automatic for most people.
If you don't apply correctly, you could miscoverage, pay penalties,
delay retirement, lose employer coverage incorrectly.
Speaker 3 (02:36):
So those are the things you have to make sure.
Speaker 2 (02:41):
So applying for Medicare when turning sixty five, you have
your initial enrollment period. You have three months before your
sixty fifth birthday and then includes your birthday month and
three months after your birthday, which becomes a three sorry
a seven month window. So those are three months before,
(03:07):
three months after, but that doesn't necessarily mean that the
month that you apply you'll get it, So meaning if
you apply three months before your birthday, it will be
issued effective your birthday month, not the birthday of your birthday,
but the first day of the month of your birthday.
(03:31):
If you do apply three months after your birthday, depending
on the month, it will be effective the following month. Okay, So,
if you're the lucky for you that are already receiving
Social Security, you're automatically enrolled and Part A and Part
B your medicare arrives by mail and you don't have
(03:54):
to worry about applying like the rest of us. Right, So,
you could decline if you're still working. So in the
back of the card there is instructions that basically state
how to decline that if you are still working, if
you're not receiving Social Security, then you must actively apply
(04:17):
online at SSA dot gov, by phone with Social Security,
or in person at SSA. But I would say online
is the easiest way. By phone, you set up an appointment,
depending you don't have to go to your local SSA office,
(04:41):
especially when they want you to make an appointment before
you come as well, So online it does get a
little bit rigorous because if you've never set up your
SSA dot gov account, you do have to set that
up by either or how can I, jeez, I do
(05:03):
this every single day for clients, So you would actually
have to have an email address and like a cell
phone or a number to verify. It is rigorous because
you create, you put your email in there, then they
(05:25):
ask you to send that email and then they will
ask you to put in your password. Then it will
generate another text and then asks you more questions. So
(05:46):
it is a rigorous process. And at the end it
will ask you to take a picture of your driver's license,
run our back or your ID, and to show your
face on your cell phone. So you really do need
to have a cell phone, okay. So then if for
(06:06):
some reason you are not able to verify like your
face or your driver's license, you'll have to go to
your local post office to get that verification to get online.
Speaker 3 (06:21):
It is a very rigorous process. So we help you
with that. No problem on that, okay.
Speaker 2 (06:29):
So what happens if you apply late? Of course, there
are coverage delays, there's late improllment penalties, and there's gaps
in healthcare. So Part A only versus Part A and B.
So this is like the biggest thing because some people
only take Part A at sixty five. But this is
(06:51):
where the mistake happens. Okay, you should only delay Part
B if you have credible employer coverage from an active
employment through an employer with twenty plus employees. Okay, because
credible coverage exempts you from that ten percent penalty that
(07:17):
you would receive by not being on Medicare at sixty five. So,
if you are on a individual plan Obamacare ACA subsidized
and cover in California, it's called Covered California, you do
need to get Medicare Part A and B.
Speaker 3 (07:42):
Okay.
Speaker 2 (07:43):
If you are working and you still have group insurance,
then that is credible. So you really don't need Part
A or Part A and B, right, if you're going
to keep your group insurance. However, some people do want
(08:03):
Part A because it supplements the hospital portion. And the
biggest thing is, do not get Part A if you
have a health savings account that you are contributing to,
because if you are contributing to health savings account, you
just can't get You shouldn't get Part A. Okay, if
(08:26):
you are working with an employer less than twenty employees,
you do have to get Medicare Part A and.
Speaker 3 (08:33):
B because why because because.
Speaker 2 (08:41):
Gosh I lost my family thought, because any plan that
is less than twenty employees is not credible coverage. Okay,
So working past sixty five, how Medicare works with employer ridge? Okay,
(09:02):
it's really confusing, right, So, large employer twelve plus employees,
employer insurance pays first. MECAN Medicare is secondary, and you
could delay Part B without penalty. So if you are
paying for your group insurance, you do not have to
(09:24):
get Part B, which you pay for, right, Like, don't
double ensure yourself and waste money by having two Okay,
Small employer under twenty employees, Medicare pace first. That's why
you do need to enroll in Part B A and
(09:45):
B at sixty five, and an employer coverage pays second.
Speaker 3 (09:50):
Okay, Okay.
Speaker 2 (09:53):
Another big question I always get is spouse's employer coverage
rules still apply based on employer size. Okay, So large employer, Okay,
you have credible coverage. You do not need to get
Part A and B. You can get Part A if
(10:13):
you don't have a health savings account, but less than
twenty employees, you will have to get coverage. So the
biggest thing on that is I typically compare your group
coverage to Medicare to see which would provide you the
(10:35):
most benefits, the lowest amount of premiums, or whatever you
would like. Right, So it's a comparison because sometimes it's
pretty straightforward. My employer plan is wonderful, I don't pay anything, right,
stay on there. But if your employer plan is not
(10:57):
that great, you're paying an arm and a leg, then
it might warrant you a comparison.
Speaker 3 (11:04):
If Medicare is better for you. Okay, So what.
Speaker 2 (11:08):
Is credible coverage? Not all employer plans qualify, so keep
that in mind. You have to be an active employee ployed.
I had this once happen right when a client was like, no, Jennifer,
(11:29):
I have I'm retired. But it is credible coverage because
they're paying for it. But once they wanted to get
on Medicare, there is a form that that employer has
to complete that basically stays how long they've had credible
coverage and active Right, So let's just say, for an example,
(11:54):
you turned sixty five, you decided to stay at work,
your group plan was pretty decent, so you stayed on
there and then let's just say at sixty seven you
decide to retire. So at that point you have to
provide the cms L five sixty form form to your
(12:17):
HR department, so they complete that and sign off that
you've had credible coverage from age sixty five to sixty seven,
so you are not penalized that ten percent every single year. Right,
So take for instance, a person didn't get that, then
they would have would be penalized twenty percent. You know,
(12:40):
two times ten twenty percent for their entire lifetime. Might
not be much for someone, but why get penalized if
you don't have to? Okay, So, like some common things
that I've seen on this as the one that I mentioned, right,
they were not active employee employed and it was they
(13:03):
got doubl eding because it was wife and husband. So
keep in mind, even if that employer is paying for
your health insurance, you might have to pay penalties because
you did not get on medicare. Right if they don't
sign that form that you've been working there since you're
since like that time, right, that you didn't have coverage
(13:26):
or had coverage with them, that that's a big thing.
I've also seen delays big companies. Guys, big companies put
the wrong date of employment and then going back and forth.
Then you might be penalized with that too, unfortunately, So
(13:49):
be very careful and mindful that your employer, you know,
will still be in business or you're going to find
someone that the HR to fill that form out right.
Most employers know about this form. You know, you're not
the only one that's retired or wanted Medicare, but you
(14:09):
know some may not. So just cognizant that in order
to avoid the penalty, they need to make sure that
it shows how long you had.
Speaker 3 (14:20):
That credible coverage.
Speaker 2 (14:23):
Okay, so not to harp again, but the Health savings warning.
Once you enroll in Medicare, you must stop contributing to
an HSA and Medicare backdates Part A up to six months.
So this mistake alone causes major tax issues. So okay,
(14:44):
let's back up because this is a little bit confusing. Okay,
so let's just say you did not apply for Part
A or Part B at sixty five. You keep work,
but let's just say you want to retire at sixty seven.
(15:06):
So when you apply for Part A and B, the
B will be effective when you want it to be, right,
like the month after you retire, right, or you don't
have coverage the Part A they backdated six months before
your part be effective date. So please keep that in mind. Right,
(15:28):
because if you're contributing to a health savings account, stop.
Speaker 3 (15:36):
Six months before you retire.
Speaker 2 (15:39):
I know sometimes you're not going to know, but just
keep that in mind because like on paper, when I
tell clients it's okay because you could just backtrack and remove.
Speaker 3 (15:51):
It from your taxes.
Speaker 2 (15:53):
But clients have told me that it has caused many
tax issues for them, right, Like really good clients that
are just they know and they're very savvy when it
comes to this, have told me it's it's a nightmare
and like it just I guess it's in a paint
(16:14):
and a butt right to bat track and figure all
that out.
Speaker 3 (16:18):
So keep that in mind as well.
Speaker 2 (16:21):
Okay, So how about when you're retiring after sixty five?
What's the steps to do for that?
Speaker 3 (16:30):
Okay?
Speaker 2 (16:30):
This is where the penalties happen most often. Your special
enrollment SEP Okay. You do have eight months after enrollment
ends to enroll in a part and part B okay,
but only two months after that to choose a Medicare
advantage or Part D plan. But the biggest thing is,
(16:51):
like I've seen this in and I've seen where people
still get penalized.
Speaker 3 (16:59):
And why wait eight.
Speaker 2 (17:00):
Months to enroll in Part B?
Speaker 3 (17:03):
Right?
Speaker 2 (17:03):
I know sometimes people have Cobra. Sometimes Cobra is still
more expensive, right I would I just wouldn't chance it
from like the issues I've seen, right, But technically eight
months after employment and that's when you could enroll, Okay,
So the critical forms is going to be the CMS
(17:24):
forty B enroll in Part B, and then the CMS
al five sixty four employer coverage verification. Okay, if I
have time, we could break that down.
Speaker 3 (17:35):
Okay.
Speaker 2 (17:36):
So common retire mistakes is waiting to long to apply, right,
And I just didn't get around to it. Cobra is
not credible credible for Medicare. So remember that I met
someone who waited one year because they were on Cobra
to get on Medicare. And she actually called Medicare and
(17:58):
asked them, is Cobra credible coverage? And they said yes,
And guess what happened? She got penalized and it took
her one year to rectify the situation. I mean, the
penalty probably wasn't as bad, but the aggravation of calling
and calling for hours on end, calling her constituents like congresspeople,
(18:23):
and it's just stressful. I probably would have just gave up. Right,
So COBRA is not credible, remember that, Okay, assuming HR
handled enrollment, human resources not. I've only had one time
which human Resources said, oh, we'll send it up to
Social Security. Don't leave it to chance. Right, We send
(18:47):
it up for clients. We do not want to leave
it to chance. Right, who knows if HR did it,
So I wouldn't leave that to a chance.
Speaker 3 (18:55):
Okay.
Speaker 2 (18:56):
Missing drug coverage deadline. Hey, when you get your Part
A hospital, Part B medical, there's an invisible drug plan there, right,
And some people were like, I don't take drugs, I
don't need a drug plan, but you have to get
a drug plan to avoid that one percent penalty. Okay,
(19:16):
So keep that in mind. So drug penalties one percent
every month that you were not on a drug plan. Okay,
added for life, which is horrible, applies even if you
don't take medications. Now, like I mentioned, okay, so choosing
(19:38):
coverage after your enroll So now what right you got
all through this.
Speaker 3 (19:44):
Congratulations.
Speaker 2 (19:46):
The Option one is original Medicare plus a medicapp plus
apart d Okay. This is the freedom to choose doctors,
freedom to go anywhere in the United States and go
anywhere that accepts Medicare, which is probably ninety nine percent
of the time. Okay. These are higher monthly premiums because
(20:07):
on top of paying your part B premium, you do
have an additional premium to pay this insurance company lower
out of pocket costs. So it's fixed because you know
exactly how much you're paying and you're deductible every year.
Speaker 3 (20:20):
It's okay.
Speaker 2 (20:22):
So Option two Medicare advantage lower premiums or even at
zero or money back. There are network restrictions, right, you have.
Most of them are HMOs. You have one doctor that
refers you to all your specialists. Sometimes there are PPO options, right,
but they're limited. They're starting to be limited, okay, prior
(20:43):
authorizations and there is maximum out of pockets depending on
the county.
Speaker 3 (20:48):
Or state you're in. You could go solo.
Speaker 2 (20:52):
There's some that are slow as one ninety nine, and
there's some higher right. So who should be careful with
advantage plans? If you're a snowbird and you're in New
York and you travel to Florida in the summers, right,
that might be a bad thing if you have multiple specialists,
(21:14):
just chronic conditions, you just prefer doctors outside of network,
or just want to go to different medical groups. That's
the disadvantage of advantage plans.
Speaker 3 (21:28):
And then there are.
Speaker 2 (21:29):
Disadvantages on metigap right the premiums. And then when you
travel overseas it's it's less coverage too. But that's probably
another topic that we will go over. Okay, So top
pip falls that costs people thousands. Okay. Mistake number one,
assuming Medicare is automatic. It's only automatic if you've been
(21:51):
on Social SSDI disability for two or more years. And
if you are getting Social Security now taking advice from
coworkers or friends. Everyone's situation is different, Okay, so keep
that in mind. Mistake number three delaying part B incorrectly
(22:13):
right if you're not an active employee, if you don't
have credibook coverage, that's a big one. Mistake number four
not understanding employer size rules. Keep in mind twenty plus
large employee credible coverage, twenty or less not credible coverage.
You need to get on Medicare. Mistake number five missing
(22:34):
Part D enrollment.
Speaker 3 (22:35):
So Part D.
Speaker 2 (22:37):
Even if you're not taking prescription drugs, now, just get
a really cheap one. Most Medicare advantage has it, so
definitely look into that. Mistake number six not reviewing plans annually.
Sometimes there's terminations, sometimes your formula, your plan changes. The
(22:58):
cost could skyrocket, right, so keep that in mind. Mistake
number seven is not planning for long term care. Many
think Medicare is going to cover it.
Speaker 3 (23:09):
It's not.
Speaker 2 (23:09):
The extended care after the skilled nursing of one hundred
days is on you.
Speaker 3 (23:15):
Right.
Speaker 2 (23:17):
If you are on Medicaid, there might be some options
for you. Some plans have a little bit of extended care,
but not all, so keep that in mind.
Speaker 3 (23:26):
Okay, So.
Speaker 2 (23:30):
Just pro tips because I do this every single day.
Apply early and not late. Okay, you just don't want
to be stressed. I've had clients where we submitted it
and it takes months to get the Part A and B. Okay,
get everything in writing of course, verify your employer size,
(23:50):
track your deadlines, review coverage annually. Work with a licensed
Medicare professional independent license agent. So I didn't have time
to go on the LMS L five sixty four and
the CMS forty B, so that's probably something I definitely
(24:13):
want to go over. Want to go over the IRMA
rates next week as well.
Speaker 3 (24:21):
So yes, I think I'm really passionate about kids. Do
it every day.
Speaker 2 (24:24):
Clients could do like an hour, and I could do
it in twenty minutes for you.
Speaker 3 (24:28):
Okay, okay, So.
Speaker 2 (24:30):
If you're turning sixty five, retiring after sixty five, or
helping a spouse or parent through Medicare, you don't have
to do this alone. At Premiere three sixty Insurance and
Financial Solutions, we do help people apply for Medicare correctly,
avoid lifetime penalties, coordinate employer coverage, choose the right plan,
(24:54):
and prepare for your healthcare costs and retirement.
Speaker 3 (24:58):
Right. I know you're probably chat GPT.
Speaker 2 (25:01):
Now all this information, but with just a guided professional
who has licensed and certified every single year to guide seniors.
Speaker 3 (25:14):
Or Medicare eligibles, we just we know the.
Speaker 2 (25:18):
Ins and outs, and I know everyone wants to do
things themselves now, but for no cost, why not have
that extended.
Speaker 3 (25:26):
Help for you? So good, easier stress.
Speaker 2 (25:32):
So thank you once again for tuning in my name
is Jennifer Alfonso Lee, your Medicare three sixty radio show hosts.
You have a wonderful Daybee.
Speaker 1 (25:44):
Thank you for joining the program Medicare at three sixty.
Hope you found today's episode insightful and empowering. Remember understanding
your Medicare options is key to making the right choices
for your health and financial well being. If you have
questions or topics you would like covered in future episodes
of Medicare three sixty, don't hesitate to reach out and
(26:07):
speak with our licensed insurance agent. Until next time, stay
informed and take charge of your health care journey. This
has been Medicare three sixty, your trusted source for all
things Medicare. Take care
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