My role in this process is really about showing people their options for Medicare from private insurance. However the majority of the time I’m helping people with what they need to do before we can proceed to review their options for a Medicare Advantage, Medicare Supplement and Medicare Prescription drug plan.
If someone is still working and covered under a large group insurance plan for themselves or through a spouse, they have an option of keeping that insurance or going onto Medicare. There are many variables to consider; what their household income is, how good is the insurance that they currently have vs. their options with a Medicare plan, and how much their group insurance 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 (Until 2020). 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 more 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. There is a form that Social Security doesn’t broadcast but exists that can be filled out and turned in that shows a sudden decrease in income so that they don’t have to pay more for their Medicare Part B and 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.