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A Roadmap to Medicare
A Roadmap to Medicare
Turning 65 or Leaving a Group Health Plan After 65 is a Big Milestone.
Let's Make Medicare Easier
There is a lot to consider when you're approaching Medicare eligibility, especially if you're still working and/or covered by an employer health plan.
We'll help you understand your options, what questions to ask your employer, and what Medicare enrollment steps you may need to consider.
A big part of the Medicare transition decision is whether to stay enrolled in an employer group health plan or transition to Medicare coverage.
The good news is...You don't have to figure it out alone
Health Care Advocates has walked thousands of customers through this decision. We find that many customers only look at it as a financial decision; however, we offer a more holistic approach, making sure to address non-financial factors such as flexibility in seeing medical providers and their networks, reviewing medical administration requirements such as navigating out-of-network care, referrals, and pre-authorization requirements, travel restrictions for routine care, etc.
Use this simple timeline to help you understand what to consider as you approach 65 or are thinking about leaving a Group Health Plan when you are already Medicare eligible
Starting early gives you time to understand your options, ask questions, and make confident decisions—without feeling rushed
Tip:
Your Medicare timeline can be impacted if you are already receiving Social Security benefits, still working & have coverage through you or your spouse's employer, or qualify for Medicare for another reason
UNDERSTAND WHEN YOUR TIMELINE BEGINS
One of the biggest misconceptions about Medicare eligibility is that you are eligible on your 65th birthday. Medicare beneficiaries become eligible for Medicare on the 1st day of the month of their 65th birthday*...NOT the day of their Birthday.
*There are exceptions to the 1st day of the 65th birthday month rule.
If you are born on the 1st day of the month, your Medicare effective date will be a month earlier on the 1st day of the month prior to the month of your 65th birthday.
Those with certain types of Social Security Disability will become eligible for Medicare 24 months after the start of their disability, regardless of age
Being diagnosed with certain illnesses, such as ESRD or ALS may qualify for Medicare regardless of age
UNDERSTANDING YOUR MEDICARE ELIGIBILITY DATE IS IMPORTANT
DO NOT GET CAUGHT THINKING YOUR ELIGIBILITY DATE IS LATER THAN IT ACTUALLY IS. THIS MAY LEAD TO RUSHED OR POOR DECISIONS OR NOT HAVING ENOUGH TIME FOR YOUR ENROLLMENT APPLICATION TO BE PROCESSED BY SOCIAL SECURITY IN TIME FOR YOUR MEDICARE ELIGIBILITY DATE
WHAT IS YOUR MEDICARE ELIGIBILITY DATE?
MEDICARE TIMELINE
MEDICARE TIMELINE
6 - 12 Months Before
6 - 12 Months Before
Turning 65
Turning 65
or
or
Leaving a Group Health Plan To Transition To Medicare
Leaving a Group Health Plan To Transition To Medicare
Expect the Mail & Phone Calls to Start Coming
Turning 65 comes with a lot of milestones—and, unfortunately, a lot of phone calls.
As you approach 65, you will likely find yourself on the receiving end of a flood of Medicare mailings, advertisements, unsolicited phone calls, and even unannounced knocks on your door, all eager to talk to you about Medicare and SELL you a Medicare Plan.
Many may come despite your efforts to limit unsolicited solicitations such as being on the DO NOT CALL LIST.
We believe there's a better way
A trusted Advisor is often referred by his or her existing satisfied clients and a trusted Medicare Advisor shouldn't have to chase you down, interrupt your day, or show up uninvited at your front door
Our business is built on relationships, referrals, and the trust of the clients we've had the privilege to serve
We do not participate in outbound unsolicited phone calls to grow our business. The majority of our business is referred by the thousands of Medicare beneficiaries that we have serviced since 2011
Our approach is simple: educate first, answer questions, and help you to understand your options so you can make a quality decision—on your terms and at your pace
3 - 6 Months Before
3 - 6 Months Before
Turning 65
Turning 65
or
or
Leaving a Group Health Plan To Transition To Medicare
Leaving a Group Health Plan To Transition To Medicare
Planning Your Medicare Transition
Turning 65 can bring a lot of questions about Medicare—and if you are not receiving Social Security Benefits or are covered under an employer health plan, your situation requires additional steps to enroll. Now is the time to start exploring your Medicare options so you can transition seamlessly—without gaps in care or Medicare late enrollment penalties.
Determining What You Need
Do you need Medicare Part A, Part B, both, or neither?
We can help you answer that; however, we need to review a few key questions:
Have you worked and paid payroll taxes for at least 40 quarters during your lifetime?
What is your current health insurance coverage?
o ACA/Obamacare
o Employer group plan
o Union plan
o COBRA
o Other coverage
Is that coverage through you or your spouse?
If you have a group or union plan, does the group have fewer than 20 employees or members?
Will your employer, group, or union plan allow you to stay enrolled after you turn 65 or become eligible for Medicare?
How much will your current coverage cost if you keep it after becoming eligible for Medicare at age 65?
(Do not include the cost of spousal, family, or dependent coverage)
If you have a group or union plan, will the plan sponsor or employer offer a payment or financial incentive for leaving the
group health plan when you become Medicare eligible?
Do you have a Health Savings Account (HSA), and are you eligible to continue making HSA contributions?
(This question applies to HSAs only, not Flexible Spending Accounts (FSAs)
Your answers will help determine whether you should enroll in Medicare Part A only and delay Medicare Part B enrollment, enroll in both Medicare Parts A & B, or delay enrollment in both Medicare Parts A and B when you become Medicare Eligible. The wrong choices can cause significant issues, including denied coverage and lifetime financial penalties
CALL US FOR HELP
mktadmin@hcafla.com 863-225-2653
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