by biggirl 1969 » Sun Apr 25, 2010 04:48 pm
He presently has medical insurance through my job, would we be better off keeping him on my insurance and turning down the medicare part B? If we turn it down and he needs it later, how long will he have to wait to sign up for it? Or is there an open enrollment period?
Posted: Mon Apr 26, 2010 06:09 pm Post Subject:
Medicare Part B (the Medical portion) is considered voluntary. If your husband is still in his group plan at work, that plan should cover all of what Medicare Part B covers and likely a whole lot more.
If he enrolls in Part B, he will have to pay a monthly premium. That premium is based on income, and most people pay about $98 per month for the coverage. Since the group plan likely covers all that Part B does, this would like be money spent that doesn't do you much.
As well, Medicare is normally considered "secondary" coverage when you also have a group plan. This is normally based on several other issues, but it's likely true for you.
As far as an open enrollment period for him, Medicare has a "special enrollment period" (SEP) for those currently enrolled in a group plan and eligible for Medicare. He will have 8 months from whenever his employment or group coverage ends (whichever is earliest) to enroll in Part B without penalty. It can't really hurt to take Part A right now as it's likely premium-free for your husband (he paid for it during his working years).
InsTeacher 8)
Posted: Mon Apr 26, 2010 08:02 pm Post Subject:
He will have 8 months from whenever his employment or group coverage ends (whichever is earliest) to enroll in Part B without penalty
Part B coverage would begin the first day of the month following enrollment under the SEP, including coverage under a Medicare Advantage (HMO/PPO) plan, if available where you reside. If he misses this 8-month SEP, then he must wait for a future General Enrollment Period that occurs every January 1-March 31, but with an ensuing lifetime premium penalty (10% for every 12 months without Medicare Part B/creditable coverage), and coverage would not be effective until July 1 of that year.
Failure to understand the importance of the SEP, and the timing of his group coverage discontinuance, could potentially expose him to almost 2 years without coverage under Part B -- payments for physicians, surgeons, and outpatient hospital expenses.
Discontinue insurance in July 2010, fail to enroll in the next 8 months (by March 31, 2011), and the earliest coverage under Part B could take effect would be July 1, 2012 (assuming he enrolls during Jan-Mar 2012). Can't even enroll in a Medicare Advantage plan in the Nov 15-Dec 31 period of 2010 or 2011, because he is not covered by Part B.
Your husband's Part A (inpatient hospital expenses) coverage is automatic at age 65, is premium-free if he is "fully insured" under Social Security or Railroad Retirement, and would be secondary to any employer-sponsored group coverage he may have unless he designates the group insurance as secondary (keeping coverage under a group policy primary forces the premium higher, and the employer will not be happy about it if his coverage under the plan is "non-contributory"). In either case, Medicare is ALWAYS secondary to any claims covered by Workers' Compensation. (Most group plans automatically exclude a spouse who reaches age 65 -- check with yours to be sure he is covered!)
Beginning in 2010, however, persons who did not pay a monthly Part B premium in 2009 ($96.40) will pay a higher monthly premium in 2010 than those who did. It starts at $110.50 (a 14.3% increase), but can be as high as $353.60 (267% more) for a person whose AGI was more than $214,000 in Tax Year 2008.
Persons who paid $96.40/month for their Part B coverage in 2009 did not have a premium increase in 2010.
[Source: Medicare & You 2010, (www.medicare.gov)]
Also, something not mentioned by my colleage InsTeacher above, if your husband does not have prescription drug coverage under the group plan, he must enroll in a Medicare Part D (prescription drug) plan, or face a 1% per month lifetime premium penalty for each month he does not have a Part D plan (or creditable coverage) prior to enrolling.
Social Security benefits and Medicare premiums for the coming year are usually announced in October or November.
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