What to Do When You’re New (To Medicare)

What to Do When You’re New (To Medicare)

When I get a phone call from someone that is preparing to go on Medicare, there are several questions that I ask to make sure they are set up properly before we meet.

You see my job is really about showing people their options for Medicare from private insurance companies (which is how I get paid and explains why my services are free). 8 times out of 10 I’m helping people what they need to do before we can proceed to review their options for a Medicare Advantage, Medicare Supplement or Medicare Prescription drug plan.

First off, if someone is still working covered under a large group insurance plan them self or through a spouse, they have an option of keeping that insurance or going onto Medicare. Variables to consider; what their household income is (if it’s higher than $170K for a married couple they’ll pay more for Part B and Part D in addition to any premiums from their Medicare privatized options), how good their insurance is that they currently have vs. options with Medicare, how much their premiums are.

If a large group insurance plan is an option for them, we also need to look their prescription drug use. On group plans there is no “doughnut hole” but on a Medicare drug plan there is. So, if someone is taking 3 or more name brand drugs a day, the likelihood of them going into the doughnut hole and consequently paying more for their prescriptions drugs is likely on a Medicare drug plan.

If someone has worked past 65 and stayed on a large group insurance plan but is now ready to retire, then there is a process with Social Security to get their Part B portion of Medicare activated (Part A typically happens automatically the month of your 65th birthday). Many times their retirement income will be much less than when they were working. There is a form that Social Security doesn’t broadcast but exists, that can filled out and turned in that shows a sudden decrease in income (Form SSA-44- Medicare Income Related Adjustment Amount-Life Changing Event and I have it electronically) so that they don’t have to pay more for their Medicare Part B or Medicare Part D, than necessary. The government bases what you pay for Medicare Part B & D on the tax return you filed two years earlier, so this can be a big savings.

Complicated? Yes...To me? No… Well, sometimes situations are unique and we learn together. Most of the time people tell me they don’t know how they could have ever gotten through the process without my help, and that’s rewarding.

Stephanie Frisch

Stephanie Frisch is the owner of Insurance 101 and is an independent insurance broker dedicated to helping others make “educated decisions” about their insurance choices when it comes to Medicare, Long-Term Care Planning, The Health Insurance Marketplace-Covered California and Life Insurance. For answers to your questions, or an in-home, no-fee consultation, call (949) 351-2443.