Anthem Medicare Supplement

Anthem Medicare Supplement - Get Quotes, Information and ONLINE Enrollment - No extra charge for our help

If your Employer Group has
Fewer than 20 employees

.

You should sign up for Part A and Part B   when you’re first eligible.   Medicare will be primary and pays before your other coverage.

 

If you don’t enroll in Part B  when you’re first eligible, you may have to pay a Part B late enrollment penalty, and you may have a gap in coverage if you decide you want Part B later.  The General Enrollment Period is quite confusing and unbelievable on how long you might have to wait. 
 

There may also be Part A penalties  if you don’t qualify for Premium Free Part A along with having to wait (Special Enrollment Periods) !

FAQ’s on should you enroll 

See more proofs and information on the rules for less than 20 employees

If your employer group has #more than
20  employees

 

Ask your benefits manager whether you have group health plan coverage (as defined by the IRS).  People with group health coverage based on current employment may be able to delay Part A and Part B and won’t have to pay a lifetime late enrollment penalty if they enroll later.

How you delay your coverage depends on your situation:

  • If you’ll be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before you turn 65, you’ll automatically get Part A and Part B. You’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday. If you don’t want Part B, follow the instructions that came with the card. If you keep the card, you keep Part B and will pay Part B premiums.
  • If you won’t be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before you turn 65, you don’t need to do anything when you turn 65.

It’s illegal for an employer to offer any incentives to encourage you to take Medicare and drop the employer plan!  Coremarkins *  The Age Discrimination in Employment Act (ADEA) prohibits employers with 20 or more employees from cancelling group health coverage for current employees due to age, even when such employees become eligible for Medicare.  SHRM *

Additional Resources:

FAQ’s

Special Enrollment Period SEP 

When you #lose Group Health Coverage
Deadlines!

When you retire, lose your employer coverage (COBRA doesn’t count! CA Health Care Advocates)   you may then enroll in Part B Doctor visits, without penalty.  See publication 10012 for more details and deadlines.

Please note, if you already have Part A, you can  enroll online, or  fill out  #application for Part B  OMB No. 0938-1230 !

You will also have a special enrollment period to get  Part D Rx and enroll in a Medi Gap Plan and Medicare Advantage.  Yes, we know this is very confusing and hard to explain or understand!

If you would like to do a Zoom meeting, here’s our calendar to set it up.

Make sure that your employers Rx Prescription coverage is credible – that is at least as good as the Standard Part D Rx Prescription  coverage so that you don’t get a late enrollment penalty.

So, basically, as long as you have great coverage at work, just sign up for Part A Hospital and then get Part B, supplements and Part D Rx when you retire.  There might be issues if your spouse wants to sign up late for Part B, as there are technical rules about it being employee coverage not COBRA, which could affect you too if you go on COBRA.

See Medicare & You Page 26 – Part B Special Enrollment Period.  Be sure to review the brochures & links below or in the right hand column!

Scroll down for more documentation.

#Important Rules for Medicare and Medicare-Eligible Members
When enrolling in a Employer Health Plan

 

You must let your employers health insurance company  know if you are enrolled, or eligible to enroll, in Medicare (Part A and/or Part B coverage).  Employer Plans are typically primary (that is, employer plan benefits are determined before those of Medicare) to Medicare for some initial period of time, as determined by the Medicare regulations. After the initial period of time, the employer plan  will be secondary to Medicare (that is, the benefits under this Health Plan will be reduced to the extent they duplicate any benefits provided or available under Medicare, if the Member is enrolled or eligible to enroll in Medicare.)

You can become entitled to Medicare three different ways: because of age, disability, or end stage renal disease (ESRD).

If you have group health insurance through a plan that either you or your legal spouse received through and Employer Group that you are actively working at, that insurance is primary over Medicare. However, there are three exceptions to this rule:

1. Employer Group with less than 20 Eligible Employees;
2. Disabled individual; or
3. Members who are entitled to Medicare due to End Stage Renal Disease (ESRD).

Medicare is primary for Employer Groups that have fewer than 20 full-and part-time Eligible Employees. Also, Medicare is primary for disabled Members if their Employer Group has fewer than 100 Eligible Employees.

If you have questions about the coordination of Medicare benefits, contact your Employer Group or our Customer Service department. For questions regarding Medicare eligibilityemail [email protected]  UHC EOC Evidence of Coverage *

Employer Dependent Definition – Up to Age 26

 

waiver uhc

Part B late problems

Excerpt from Medicare Rights.org 

 

Medicare Advantage Guaranteed Issue 

When you lose Employer Coverage

guaranteed issue MAPD & Rx loss of employer plan

Our webpage on Guaranteed Issue & Enrollment Periods for MAPD Medicare Advantage & Part D Rx

Enrollment Dates

For Part A Hospital 

 

If you’re eligible for premium-free Part A, you can enroll in Part A at any time after you’re first eligible for Medicare. Your Part A coverage will go back (retroactively) 6 months from when you sign up (but no earlier than the first month you are eligible for Medicare).

If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, you may have to pay a penalty.

Note

Premium-free Part A coverage:

  • Begins 6 months back from the date you apply for Medicare (or Social Security/RRB benefits). To avoid a tax penalty, you should stop contributing to your Health Savings Account (HSA) at least 6 months before you apply for Medicare if you delayed enrollment Medicare.Gov
  • Begins no earlier than the first month you were eligible for Medicare.
  • Be careful, even what I’ve copied from Medicare.gov doesn’t always make sense or is 100% correct for your situation.  Set a Meeting – Zoom, Skype or Phone  to go over it. 

 

Enrollment Dates are different for 

every piece or option of Medicare,  (MAPD, Rx, Medi Gap, Part A, Part B, etc.) is talking about.

Enrollment Dates for MAPD – Medicare Advantage & Part D Rx

It’s imperative that you double check everything and don’t listen to any Rando’s on the Internet or some BOZO on the phone!  Another definition of Bozo.   It’s very critical and confusing!!!

 

Links, References & Resources

See Medicare Publication 02179 for information on having dual coverage with Medicare.

official Medicare  link  to enroll in Medicare Part A Hospitalization and Part B Doctor Visits.

Kaiser Information & FAQ’s
Transition Employer Plans to Medicare

Since you have coverage through work, you can probably postpone enrolling in Part B – Doctor Visits and Part D Rx.

Learn More ===>

the horses mouth on if you should get Part B Doctor Visits, how to enroll, COBRA Traps, etc.

Medicare Eligibility & Premium Calculator Tool

Part B Late Enrollment Penalty

PBS News Hour FAQ’s Employer vs Medicare

28 comments on “Medicare enrollment, if covered by Employer Plan? Retiring?

  1. I misunderstood and did not file for Medicare part B in time when I retired in June.

    Now Kaiser has terminated my health care retirement benefit. I am enrolling now. [In Part B]

    What options do I have or have I lost retirement health care through Kaiser forever?

  2. Can I keep my group plan with over 20 employees and get an MAPD plan. I want the hearing aid benefits.

    • Here’s the thought process, please read all the research.

      If you need more citations, let me know.

      See the comparisons and premiums we previously sent you privately. Website visitors can visit our other pages on MAPD, some Medi Gap policies may cover hearing aids? Be sure to double check. We have posted the EOC Evidence of Coverage or email us [email protected] and we will get it for you.

      You won’t be able to collect double.

      See our FAQ below on how to sign up for Part B

      FAQ from Enrolling in Medicare Parts A & B Page 19

      I’m still working and have health coverage from my employer. My husband is turning 65 this April. If we decline Part B and decide to enroll at a later date, will we have to pay a late enrollment penalty?

      No, as long as you’re eligible for and enroll during a Special Enrollment Period. If you wait to enroll in Part B because you or your spouse are working and have group health coverage through an employer or union based on this current employment, you can enroll during a Special Enrollment Period.

      You can sign up for Part B during one of these times:

      Any time you’re still covered by an employer or union group health plan, through your or your spouse’s current or active
      employment

      Special Enrollment Period— Page 12

      Once your Initial Enrollment Period ends, you may have a chance to sign up for Part A (if you have to buy it) and Part B during a Special Enrollment Period, but only if you meet certain requirements. If you’re covered under a group health plan based on current employment, you have a Special Enrollment Period to sign up for Part A and/or Part B at any time as long as you or your spouse (or family member if you’re disabled) is working, and you’re covered by a group health plan through the employer or union based on that work.

      If you enroll during a Special Enrollment Period, your Medicare coverage typically begins the month after Social Security gets your completed request. Usually you don’t pay a Part B late enrollment penalty if you sign up during a Special Enrollment Period.

      OOPS!!! Here’s a snag. Getting Part B with an effective date under the General Enrollment Period of July 1 or Special Enrollment of say April or May 1, doesn’t necessarily allow you to get a MAPD plan.

      I checked more****

      If one were to drop their Employer Plan get Part B, then they could get MAPD. My source says you can’t have MAPD and Employer Plan at the same time. See # 14 above under the typical questions one gets asked when they want to enroll in a MAPD plan outside of AEP Annual Election Period I double checked… I would feel more comfortable if I could show you an actual law or something.

      Does it make sense to pay $148.50 Part B premiums and possible premiums for MAPD to get coverage for hearing aids?

      See our webpage on Medical Loss Ratio

      As you can see from this page and the rest of our website, I don’t like to say anything unless I have absolute proof – citations…. That’s I’ve read it three times and when I think I understand it, read it again.

      Note that Medi Cal doesn’t allow HMO and other Insurance!

      Here’s a typical EOC Evidence of Coverage on how MAPD pays if you have an Employer Plan

  3. FAQ

    I’ve retired early, I’m not 65 yet

    What do I do for Health – Medical Insurance?

    There are plenty of Health Plans in the Individual Market.Get quotes here.  

    If your MAGI income is below 400% of Federal Poverty Level you may even qualify for subsidies – tax credits.

    Get a complementary quote, benefits, rates & subsidy calculation for California here.  

    If you are 62+ and getting Social Security some of your Social Security is taxable and counts towards MAGI income for subsidies.

    If you are disabled, you get Medicare after two years of SSDI.

    If you can really live on a budget or are unfortunately forced to,  there is Medi-Cal if you are under 138% of Federal Poverty Level.  We don’t get paid to help you with that, so just contact Medi-Cal directly.

    Check out the Retirement Section of our website.

    *************

    Jacob F says:

    I retired from North Carolina State University july 2018.

    They told me that they would supplement my medicare to the same level of medical insurance I had before, but when I asked them how to enroll for that they were less than helpful.

    I have social security and they pay a monthly premium

    I don’t know whether I am enrolled or what to do to enroll or what exactly I am covered for or what to do.

    Reply
    1. Anonymous says:
      Are Medigap policies written during the 8-month Special Enrollment Period issued subject to the same terms as terms, with regard to pre-existing conditions, as those written during the Initial Enrollment Period?
      Reply
    2. Anonymous says:
      How do I show Medicare that I had qualifying employer coverage?
      Reply
          • When did you turn 65? Do you have a 1095 B or C form? That shows you had coverage, to avoid ACA/Obamacare mandate penalty.

             

            Here’s what the FEHB says:

            What Happens If I Don’t Take Part B as Soon as I’m Eligible?

            If you do not enroll in Medicare Part B during your initial enrollment period, you must wait for the general enrollment period (January 1- March 31 of each year) to enroll, and Part B coverage will begin the following July 1 of that year. If you wait 12 months or more, after first becoming eligible, your Part B premium will go up 10 percent for each 12 months that you could have had Part B but didn’t take it. You will pay the extra 10 percent for as long as you have Part B.

            If you didn’t take Part B at age 65 because you were covered under FEHB as an active employee (or you were covered under your spouse’s group health insurance plan and he/she was an active employee), you may sign up for Part B (generally without an increased premium) within 8 months from the time you or your spouse stop working or are no longer covered by the group plan. You also can sign up at any time while you are covered by the group plan. https://www.opm.gov/healthcare-insurance/healthcare/medicare/medicare-part-b-coverage/

            Reply
    3. Anonymous says:

      Thank you for responding to my question on Sept. 25th

       

      I still don’t see an answer to my question as to whether the parent must be currently working or if having group insurance as a retiree from the parent’s former employer provides the same protection to not incurring a penalty.

      This is a wonderful service you’re providing and I will be sure to refer my friends to you for their insurance needs.

      Reply
    4. Anonymous says:
      I’m disabled and covered under my Dad’s retirement plan. I just qualified for Medicare. Must I enroll in Part B or can that be postponed as I have employer coverage?
      Reply
    5. Anonymous says:
      Wow! Thanks!
      Reply
    6. Anonymous says:

      I turned 65 a few months ago, I’m still working and I’ve stayed on my employers group plan.

       

      1. If I cancel my current medical insurance, with my employer, then I guess I would need to sign up for Medicare part “B”, right?

      2. My income probably falls into the first tier so there would be a premium of $134 +/-

      3. Then I would need a Medicare Supplemental plan like my High Deductible F so another premium of $75 or so, right?

      4. Then another supplemental Prescription Plan Part D with a premium of around $40

      5. Also, my Granddaughter, whom I have legal custody of is on my group plan, so I would need to get individual coverage for her, right?

      6. I believe that was around $350 for a plan I liked.

      7. So I would end up with an estimated monthly expense of:

      Part B Medicare $134
      Plan Hi F Medi Gap $75
      Part D Rx $40

      Individual Plan for Grand daughter

      $350

      For a total of $599

      8. On Medicare Part “B” how would she pay that premium?

      A. Monthly bank withdrawal?

      Reply
  4. My wife turned 65 in April of 2019.

    She didn’t apply for Medicare at the time because she is covered under my work health plan.

    Company is Trader Joes and It’s a Blue Shield HMO.

    She now wants to enroll in Medicare and purchase a medigap plan.

    For the possible need of longer term physical therapy her doctor recommended a medigap program due to the limitations of an HMO on number of sessions allowed in a year.

    Can she enroll now and not wait for the enrollment period because she has been under an employer plan and can she do so without a a penalty for the same reason.

  5. I have a question about Medicare enrollment. I’ve been given conflicting info and need advice.

    I have insurance through my work so I am confused about enrollment in Part A.

    Can I enroll only in part A or do I have to enroll in Part B too?

    The Medicare website says I must enroll in both but I don’t need Part B. What do I do?

    Don’t want to miss out on Part A.

    • See the webpage above for your answers and citations. Please advise where exactly Medicare says you have to have both. While there are late enrollment penalties, see above for how they are waived if you have employer coverage.

      https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/should-i-get-parts-a-b

      I’m currently working, and I have coverage through my job.

      The size of the employer determines whether you may be able to delay Part A and Part B without having to pay a penalty if you enroll later.

      The employer has fewer than 20 employees.

      You should sign up for Part A and Part B when you’re first eligible. In this case, Medicare pays before your other coverage. Learn more about how to get Parts A and B.

      Note

      If you don’t enroll when you’re first eligible, you may have to pay a Part B late enrollment penalty, and you may have a gap in coverage if you decide you want Part B later.

      The employer has 20 or more employees.

      Ask your benefits manager whether you have group health plan coverage (as defined by the IRS). People with group health coverage based on current employment may be able to delay Part A and Part B and won’t have to pay a lifetime late enrollment penalty if they enroll later. If you want to delay both Part A and Part B coverage, you don’t need to do anything when you turn 65.

      If you’re eligible for premium-free Part A, you can enroll in Part A at any time after you’re first eligible for Medicare. Your Part A coverage will go back (retroactively) 6 months from when you sign up (but no earlier than the first month you’re eligible for Medicare).

      If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, you may have to pay a penalty.

      Note

      Premium-free Part A coverage:

      Begins 6 months back from the date you apply for Medicare (or Social Security/RRB benefits). To avoid a tax penalty, you should stop contributing to your Health Savings Account (HSA) at least 6 months before you apply for Medicare.
      Begins no earlier than the first month you were eligible for Medicare.

      When the employment or employer/union coverage ends

      Once the employment (or your employer/union coverage) ends, 3 things happen:

      You may be able to get COBRA coverage, which continues your health insurance through the employer’s plan (in most cases for only 18 months) and probably at a higher cost to you.

      You have 8 months to sign up for Part B without a penalty, whether or not you choose COBRA. To sign up for Part B while you’re employed or during the 8 months after employment ends, complete an Application for Enrollment in Part B (CMS-40B) and a Request for Employment Information (CMS-L564). If you choose COBRA, don’t wait until your COBRA ends to enroll in Part B. If you don’t enroll in Part B during the 8 months after the employment ends:

      You may have to pay a penalty for as long as you have Part B.

      You won’t be able to enroll until January 1–March 31, and you’ll have to wait until July 1 of that year before your coverage begins. This may cause a gap in health care coverage.

      If you already have COBRA coverage when you enroll in Medicare, your COBRA will probably end. If you become eligible for COBRA coverage after you’re already enrolled in Medicare, you must be allowed to take the COBRA coverage. It will always be secondary to Medicare (unless you have End-Stage Renal Disease (ESRD) . Learn more about how Medicare works with other insurance.

Leave a Reply

Your email address will not be published.