I have an employer health plan currently and plan to retire soon. What steps do I need to take to transition to Medicare?
Transitioning to Medicare can be a confusing nightmare if you don’t know what to do. There are a few steps to take and below is a helpful guide to what you will need to do.
1. Determine the date your employer plan will end.
2. If you do not currently have Medicare Part B (Medical) you will want to contact Social Security to have Medicare Part B (Medical) effective when your employer health plan ends. To learn more about what Part B is see www.SeniorSavingsServices.com/Medicare-Options.
- Tip: To contact Social Security you can stop at a Social Security office. (Find your closest Social Security office here: https://www.ssa.gov/locator.) It is best to get there first thing in the morning to avoid long lines to wait. Alternatively, you can contact Social Security on the phone at 1-800-772-1213. To avoid having to wait on hold to reach someone, Social Security has a process where you can enter your phone number and they will call you back when it is your turn, and speaking from experience this does work.
3. Learn about Medicare Supplement Plans, which can be used nationwide, versus the Medicare Advantage Plans, which are either an HMO or PPO plan that has a network of certain hospitals and doctors to use. Decide which will be best fit for you.
4. Decide if you need a Medicare Part D Prescription Drug Plan. You can enroll in a Prescription Drug Plan up to 2 months after your employer health coverage ends.
- Tip #1: If you don’t enroll in a Prescription Drug Plan during this period of time you are not able to enroll in a plan until the Medicare Annual Election Period, which is October 15th thru December 7th. Further, Medicare will penalize you for not having enrolled in a Prescription Drug Plan from the period of time when your employer health plan ended to when you start a Medicare Part D Prescription Drug Plan. To learn more about the Part D penalty see: www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html
- There are a few situations where a Medicare eligible member is able to avoid a Part D penalty and enroll any time of year. Consult with an insurance broker to learn if you can benefit from one of these situations.
- Tip #2: When you enroll in a Prescription Drug Plan after having had an employer plan you might receive something in the mail requesting proof that you have had a prior prescription coverage. Providing something showing you had an employer plan will be sufficient. If you don’t provide anything Medicare will penalize you for not having had coverage with prescription coverage.
It is always a good idea to see if your employer plan can continue with you in retirement. If so, what does the coverage provide? Is there a cost associated with keeping your employer plan into retirement? How does the coverage compare to choosing a Medicare Supplement Plan or Medicare Advantage Plan instead?
Consult with an insurance broker to learn about your Medicare plan options so you can best compare and be informed. You can benefit tremendously and save yourself a lot of time doing this. Trying to find which companies and plans are available and then to look up and contact each company will take you a very long time. Make this an easy transition for yourself.
About the Author
John Bush has been an independent insurance broker helping those on Medicare learn of their rights and options since 2010. He has helped many people find the right plan that is best for them. John is passionate about helping people in a manner that is easy to understand, resourceful, and non-pushy. John helps people get the best coverage for their premium dollar without sacrificing customer service.