Dropping Group for Medicare

[toc3]

One of the biggest problems comes when the employee realizes that his spouse no longer has insurance, and now he has to buy a policy for her if she is under 65 and it costs big bucks!!.... and now he can no longer go back to his group. "Dropping group" is not like leaving a Med Sup.... Expect a lawsuit.

Excellent advice. I had actually thought of all these issues except her spouse. Maybe because she told me that it was just her on the group but I still should have thought of the spouse before she mentioned it. Thanks again retread.

 

[retread]

One of the biggest problems comes when the employee realizes that his spouse no longer has insurance, and now he has to buy a policy for her if she is under 65 and it costs big bucks!!.... and now he can no longer go back to his group. "Dropping group" is not like leaving a Med Sup.... Expect a lawsuit.

Excellent advice. I had actually thought of all these issues except her spouse. Maybe because she told me that it was just her on the group but I still should have thought of the spouse before she mentioned it. Thanks again retread.

Glad to help.... also Rick brings up a point I failed to mention, and many agents don't consider, and that is that group Rx coverage does not have coverage gaps (donut hole)... that is unique to PDPs (... thanks to CMS) so the client has no idea what awaits him if he takes a lot of Rx. Remember, groupies are not savvy to Medicare.

 

[G.Gordon]

Glad to help.... also Rick brings up a point I failed to mention, and many agents don't consider, and that is that group Rx coverage does not have coverage gaps (donut hole)... that is unique to PDPs (... thanks to CMS) so the client has no idea what awaits him if he takes a lot of Rx. Remember, groupies are not savvy to Medicare.

More and more plans that cover retirees and those on medicare and still on group are adopting Part-D limits. I see this as an attempt to eliminate the benefit for those under this circumstance to stay on the sponsered plan.

 

[azmedsupagent]

Employers are gleeful that employees drop group for any reason.... it saves the employer money. What you need to do is have them call HR as has been said several times... this is very important. It is HRs job to tell them what they are losing in terms of benefits. "Dropping group" usually entails also dropping dental and other benefits.... sometimes a small term life policy, too.

One of the biggest problems comes when the employee realizes that his spouse no longer has insurance, and now he has to buy a policy for her if she is under 65 and it costs big bucks!!.... and now he can no longer go back to his group. "Dropping group" is not like leaving a Med Sup.... Expect a lawsuit.

Think these things through on behalf of the client... don't let your commission drive your thoughts.

THAT IS EXCELLENT ADVICE!!

 

[retread]

More and more plans that cover retirees and those on medicare and still on group are adopting Part-D limits. I see this as an attempt to eliminate the benefit for those under this circumstance to stay on the sponsered plan.

Thanks for that info.... I usually tell those on Group to check with their HR department before I go any further. I advise them that they are most likely in a better plan than a Medicare Advantage plan can give them...

If they are T-65 (which is rare for me) I get them to consider opting out of Part B if they continue to work and save that $96.40/mo if they have group insurance. I caution them to call me immediately if they retire or lose group, whichever comes first. (Usually T-65s don't call agents, they "do-it-themselves", and don't know their option for Part B. I have clients 67+ lament "I wish I had known this, I could have saved a ton of money!" )

 

[G.Gordon]

Just had that same conversation with a lady gathering information for her husband. He's T65 and still going to work a couple of more years. I told her to call HR, ask if their group required a person to activate part B or just have part A. She called me back saying they told her that he did not need to have part B yet. She was glad to realize that they didn't have to start paying yet. But you are right, most folks that "Do It Myself" under these circumstances lose out. Another problem with relying on the "authorities" like 800Medicare or SHIP instead of "paid experts" like us.

 

[retread]

Just had that same conversation with a lady gathering information for her husband. He's T65 and still going to work a couple of more years. I told her to call HR, ask if their group required a person to activate part B or just have part A. She called me back saying they told her that he did not need to have part B yet. She was glad to realize that they didn't have to start paying yet. But you are right, most folks that "Do It Myself" under these circumstances lose out. Another problem with relying on the "authorities" like 800Medicare or SHIP instead of "paid experts" like us.

You are right about "paid experts"... there is nothing like having to earn your income by a professional approach, rather than a bureaucrat that draws a salary by just showing up for work!

But Rep. Stark thinks we are overpaid!