Guaranteed Issue Medicare Rights

KNOW YOUR MEDICARE RIGHTS WHEN COMING OFF A GROUP PLAN

Did you know you may qualify for a Guaranteed Issue Medicare Right if your employer coverage is considered creditable?  Each year there is a greater percentage of employed seniors that are eligible for Medicare and according to the Bureau of Labor Statistics it grows each year. Though we don’t know what the future holds… from past experiences things are only getting more expensive so seniors are compensating and working longer and are on group coverage longer.

When retirement is right around the corner where do you go for answers? What are your options? Will you be able to obtain coverage if you have pre-existing health conditions? These are all some questions that you might be asking yourself.

When the Affordable Care Act (Obamacare) went into effect in January 1, 2014 we learned it requires primary insurance to not ask health questions. In the past, we have learned that a lot of people think that Obamacare and Medicare Supplements work the same way. But they don’t… no worries because we are here to walk hand in hand with you through the Medicare maze. The good news is when you are coming off a creditable group plan on to Medicare, you qualify for a Guaranteed Issue Period as part of your Medigap protections.

THINGS TO CONSIDER WHEN YOU QUALIFY FOR A GUARANTEED ISSUE MEDICARE SUPPLEMENT

There are many ways you could qualify for your Guaranteed Issue Medicare rights. Today, we are going to talk about how you can qualify after losing group coverage and when, where, and how to get adequate coverage by choosing a Medigap policy.

If you currently have original Medicare and you are coming off a group plan that has creditable coverage, you may have the right to buy Medigap Plan A, B, C, F, K, or L that are available in your state (to view rates in your area please click HERE). You will need to apply for a Medigap/Medicare Supplement policy no later than 63 calendar days after the latest of the following three dates:

  1. Date the coverage ends
  2. Date on the notice you get telling you that coverage is ending (if you get one)
  3. Date on a claim denial, if this is the only way you know that your coverage ended

Also, make sure to keep these items handy:

  • A copy of any letters, notices, emails, and/or claim denials that have your name on them as proof of your coverage being terminated
  • The postmarked envelope these papers come in as proof of when it was mailed.

We ask that you save these documents because you might need to send a copy of some of these papers with your Medicare application to prove you have a Guaranteed Issue Medicare right.

Figuring out what the best step to take when coming off group cover is tricky. Let us help you find the right plan for you. Give us a call today and we can help you sort through your options! Our number is (877) 759-5760.

For information on additional Guaranteed Issue Medicare Rights, please click the following link: http://www.medicareinsurancefinders.com/enrollment-periods/guaranteed-issue.html

Source: Medicare.gov

Guaranteed Issue Medicare Righs: Know your Medicare rights. Give us a call!

Group Insurance or Medicare

With over 25 years in the insurance industry our company has received all types of questions from clients and business owners pertaining to their insurance.  However, there is one that is popping up more and more now that people are working longer and that is “do in need group insurance or Medicare now that I am 65″. Unfortunately, we can not give a one size fits all answer to this question.  There are different factors that come into play like: high income penalties, group insurance rates (your portion), how many employees does your company have, and several other factors that must be considered if you want to make sure that you do the best thing for your coverage.

Compare Group Insurance or Medicare

Group insurance is coverage that is provided by your employer.  Medicare is a federal health insurance program that is broken up into four parts (A, B, C, D).  Part A is funded by payroll tax and Part B is partly government subsidized and partly insured paid.  The question we are covering is which coverage is better for you when you reach age 65, group insurance or Medicare.

The first thing you need to do before you do anything is ask yourself when you are going to retire.  If you are retiring at age 65 – it doesn’t matter which is better because when you quit working your group insurance goes away!  If you are going to continue working then you will need to do the following steps:

  1. Tally up your costs.  Find out what your group health insurance is costing you.  Is it subsidized 100% or do you have to pay 50% of the cost.
  2. Income.  What is your income and do you fall under the high income thresholds of Medicare?  A single individual reaches the high income level at $85,000 per year in 2013.  Depending on your income level it may not be cost efficient to enroll in Medicare Part B.
  3. Company Size.  Medicare is primary for under 20 employees and secondary coverage for groups over 20 lives.  There are different options like a group retiree medical plan that can be offered for those groups with less than 20 employees which can save the employer and employee a lot of money.  It is group insurance or Medicare – you might be wondering?  It is a supplemental insurance built for a group.  Click Here to find out more about this plan.

There are other factors that are a little more complicated than I would like to present in an article but just know that when you are comparing group insurance or Medicare you need someone who knows what they are talking about.  Not just a regular health insurance agent, but someone who specializes in Medicare.   Call 1-877-936-2991.

Group Insurance or Medicare Example

I had a business owner call a few months ago and he was a high income earner ($500k+).  Due to the penalty with Medicare and his low premiums for his group health plan.  It was not cost efficient for him to leave the group plan.  It was going to be $400 more per month or $5,000 roughly per year.

If you are leaving the group plan make sure to get a Medicare Supplement.  Most people want a plan that covers the gaps and allows you to go to any Medicare doctor.  Medicare Advantage plans change each year and it is not a plan that you can hang your hat on.  We hope you enjoyed this article and please don’t hesitate to share.

 

Group Insurance or Medicare

Offering Supplemental Medicare plans – Medigap and Dental Insurance

Detroit Retiree Insurance

Detroit Retiree Insurance is currently taking some hits in the news, talking about how there is currently 5.7 billion in unfunded retiree healthcare liabilities, nearly 1/3 of Detroit’s debt.  Currently there are almost 20,000 retirees in Detroit that will be pushed towards the exchanges for their insurance options due to Detroit Retiree Insurance issues.

Life most companies that have promised to cover retiree benefits, Detroit is struggling to live up to the promise that was made when insurance rates where not increasing at 10% per year and MRIs where not costing $2,000 a pop.  Most municipalities, unions, companies and associations are changing over to Individual Medicare Supplement Plans or Group Retiree Medical Plans that are sponsored by the group but not funded by the group.

Detroit Retiree Insurance – Could either of these options work?

  1. Individual Medicare Supplements – yes, this is an option that would take the liability off the the Detroit Retiree Insurance fund.  However, it would put the premium payments on the back of the individual.  No one wants to suggest this option because they would not receive votes the following year. 
  2. Group Retiree Medical Plan – this would be another option that would work but would cost the individuals and would not be appreciated by the workforce that contributed to the city of Detroit!

Can an individual currently on the Detroit Retiree Insurance Plan switch to a Medicare Supplement or another supplemental plan?

The answer is yes!  These individuals can go to another plan stating that they are in good health.  You may be wondering what if their health is bad – is there any option? Yes the option is to purchase a BAI Guaranteed Issue plan.  To learn more about these plans you can click here.

If you need help with your health insurance options don’t hesitate to call us at 1-877-936-2991.  We provide insurance solutions in all 50 states and are not limited by one company.  We are a brokerage that represents hundreds of companies and provides you with a quote engine that shows you which plan has the lowest premiums with the best benefits.

 

 

 

Employers – How to handle Seniors on Group Health Insurance?

All across the country right now employers are looking for ways to lower health insurance premiums.  There are a lot of different coverage issues that many different employers are facing – depending upon their industry.  Fast food restaurants are trying to figure out how to keep down their full time employees while giving them enough hours to stay happy.  Other employers are trying to figure out how to handle their 65+ seniors on group health insurance.

This article will strictly focus on how to lower health insurance premiums by lowering the average age of the group.  It will also show you how to provide better coverage for those 65 and older on your current plan.

Seniors on Group Health Insurance (65+ and Retirees)

In case you don’t know, those who are 65 or older are eligible for Medicare.  This is the federal health insurance program that covers roughly 80% of your healthcare expenses.  Upon turning 65 you receive Medicare Part A and can elect to receive Medicare Part B for a premium.

However, some individuals are still working and there are other considerations for those individuals.  In example seniors on group health insurance need to know:

  • Employers with less than 20 employees: Medicare is the primary insurance
  • Employers with more than 20 employees: Medicare is the secondary insurance
  • You may not want to enroll in Part B if Medicare is secondary coverage and you have good group health insurance.  It will save you from having to pay a premium.
  • Seniors can enroll in Medicare Part B anytime their group health insurance is ending (Voluntary or Involuntary – COBRA and Retiree Insurance does not count as group health insurance)

The Million Dollar Question

What options do employers have to help their seniors on group health insurance while not kicking them off the plan?

 

Employers can implement a group retiree health insurance plan!  A group retiree health insurance plan is not just for those individuals who have retired from the group.  Below is a list of the seniors that can enroll in these group retiree health insurance plans:

  • Retirees of the group
  • Spouses of active employees (Plus or Minus 20 employees)
  • Active Employees (Under 20 Employees)

Benefits can be substantially better while saving the employer large amounts in their premiums.  The other day we were working with a group that was able to offer a “Modified Plan F” to their retirees and employees that were over the age of 65 and lower his premiums at the same time.  A Modified Plan F is basically 100% coverage minus small co-pays for doctors visits.  If you would like to see a similar plan you can visit Benefits Association Retiree Package to see how their benefits are structured.

This is a great way for employers to save on their group health insurance and help their older employees at the same time.  For more information on how to offer Retiree Health Insurance call 1-877-936-2991.

Seniors on Group Health Insurance

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