Thursday, August 28, 2008
I have medical insurance through my job. do I have to sign up for medicare when I turn 65 or can i opt out? -
My job pays for Blue Cross blue shield medical and prescription coverage. I want to continue this and not go on medicare. Depends! The question behind your question will vary depending on the two below scenerios. #1 The group is 20+ Employees. The medical plan will remain primary over Medicare pursuant to the Medicare Secondary payor act. There would be no penalty for waiving medicare. #2 The group is under 20 employees and clasified as a small group business. The medical plan in this case can do something called Medicare Estimation and not required to comply with the secondary payor act. This will enable the carrier to estimate what Medicare would have paid and apply credits. In this scenerio, you would have signficant incentive to enroll in both Medicare A B. Call your carrier and ask them what is your Tefra provision. They should indicate either Medicare Prime (Option #2) or Medicare Secondary (Option #1). Be extremely cautious as Medicare has open enrollment periods and if you waive you may not be able to re-enter timely. Also, you may want to reach out to the employer to advise if they have any group level medicare advantage plans. These plans are normally more cost effective and allow you to treat within the carriers same network. This will be especially important if you contribute to your own premiums through payroll. You automatically qualify for Medicare at the time of retirement, at 65 you qualify for what they call Medicare Part B. if you opt in (depending on your income) it will cost at the lowest $96.46 per Month and they will deduct that amount from your Social Security that you received every month. This covers the Physicians and Doctors that you will be needing at that time. You can certainly opt out, and not buy it, you are hoping to have your Blue Shield continue to cover your medical needs. But compare the deductible and coverage that you are paying with your private insurance. You might want to consider Medicare Advantage Plan, what they called Medicare Part C, which will cover the Hospital, the doctors and your prescription drugs with no additional premiums. It might be better than the Blue Shield that you have. check it out at the medicare website It also depends on what state you're in. Some states allow the employer to decide whether you can continue GROUP coverage or not. You can choose to stay on the Blue Cross, regardless, but you may not be able to stay on the group plan. Blue Cross also has great prices on their Medicare Supplements. Before you take any advice off the internet, you need to talk to your employer and a licensed insurance agent in your state to find out what your options really are. Don't forget, in all states, you get a "stupid tax" of 12% per year for not buying parts B and D when you should have. This is not applicable if you're covered under group coverage. Depends on the size of your company. If the group is under 20 full time employees, the emplyer can elect to have Medicare be the primary carrier for its over 65 employees. If it does this, then you would have to enroll in parts A B and D. If the group is over 20 FTEs, it doesn't have the option, but may be keen to have you opt out of their health plan and on to Medicare. This lowers their average age and exposure. That said, they cannot pressure you OR directly induce you to drop the emplyer paid plan. Its your choice.
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