Senior Advocate: Your employment affects decision-making on Medicare
Aug
6
Written by:
8/6/2009 11:23 AM
By Betty Berry
Wednesday, August 5, 2009
Q: I am about to turn 65 and had planned to enroll in Medicare; however, a friend told me that since I was going to continue working, I shouldn’t enroll until I quit.
Can you explain how my continuing to work has any effect on when I should sign up?
A: Your question is one that many struggle to understand and your friend’s advice could be correct or incorrect depending on your particular situation.
First you must understand that Medicare consists of several parts. Part A is hospitalization coverage, Part B is medical coverage and Part D covers prescription drugs.
Medicare Part A comes to beneficiaries with no monthly fees. All beneficiaries should sign up for this coverage when they turn 65.
Medicare Part B — for doctor services, lab fees, etc. — comes with a price tag. There is a monthly premium for this coverage. Whether you should sign up for this coverage depends on whether you plan to continue working.
If you are 65 or older or if you have a spouse of any age who is working and either your or your spouse’s employer has 20 or more employees, that employer must offer you the same health insurance that is offered to younger workers and their spouses.
This rule also applies if you or your spouse is self-employed and covered by a plan through connection with a firm that has 20 or more employees.
You may accept or reject any employer’s plan that is offered. If you accept the plan, it will be your primary healthcare coverage.
You can enroll in Medicare Part B if you wish; it would become your secondary coverage. If the employer’s plan does not pay all of the charges, Medicare Part B may pay secondary benefits for Medicare-covered services.
It could also help to pay some of the expenses the employer’s plan may not cover if those expenses are Medicare covered items.
Whether you wish to enroll in Medicare Part B will depend on how fully the employer plan covers doctors and health services. You need to consider whether the secondary benefits Medicare Part B would provide are worth the monthly cost.
If you choose to reject the employer’s plan, then you most certainly should enroll in Medicare Part B. It will be your primary coverage.
If you make that choice, the employer plan cannot become a supplemental plan to Medicare.
If you feel you need additional protection to cover what Medicare doesn’t cover, you must then consider purchasing a “medigap” policy.
You can, if you wish, also keep the employer’s plan if it offers coverage for non-Medicare-covered items such as hearing aids, vision tests and glasses and routine dental care. Again, you will want to consider the cost.
Medicare Part D covers prescription drugs. A beneficiary who has enrolled in Part A and/or Part B is eligible for this coverage. If you opt for an employer’s plan and it has prescription drug coverage that is equal to or better than Part D coverage, you do not need to enroll in Part D.
As long as you or your spouse continues to work and is covered by an employer’s plan, you can postpone enrollment in Parts B and D until you stop working or the employer discontinues the plan.
At that time you have seven months to enroll without penalty for signing up past age 65.
Happenings
Friday: Seminar on Medicare basics: 1 to 3 p.m., Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks; facilitated by the Senior Concerns Advocate. For more details, call 800-600-4182.
Aug. 12: A Taste of Cypress & Classic Car Show: 5:30 to 7:30 p.m., Cypress Place Senior Living, 1200 Cypress Point Lane, Ventura; return to the ’50s for this Alzheimer’s Association fundraiser. For reservations, call 650-8000.
— Betty Berry is a senior advocate for Senior Concerns. The advocates are at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362; 495-6250. You are invited to submit questions on senior issues.