Medicare 1st of Month Birthday

[somarco]

Many people, especially seniors, don't know that your Medicare effective date can be a month before you turn 65. Someone born on May 1 discovers their Medicare coverage actually started April 1. This often does not happen until they receive their Medicare card.

Just happened with a new client who applied for Medicare a few months ago is still working, and covered by the EGHP through the end of May.

He is also subject to IRMAA.

Now he has EGHP + Medicare A&B (effective April 1) but he didn't want Medicare to start until June 1.

Unless there is a way to unwind this and start over, he is paying Part B for April & May plus IRMAA (the maximum) and doesn't want or need Medicare now.

 

[TwoCents]

This is going to go a lot deeper than just having a birthday on the first of the month and that particular rule. Some play the game better than others and I don't really feel like thinking of the angles, but the Medicare initial enrollment period will trump the SEP for losing EGHP.

I won't say for certain that your client can't get Medicare to start June 1, but yeah, he can't get Medicare to start June 1. haha There are plenty of posts about it, but I'm not going down that rabbit hole.

 

[somarco]

This is going to go a lot deeper than just having a birthday on the first of the month and that particular rule. Some play the game better than others and I don't really feel like thinking of the angles, but the Medicare initial enrollment period will trump the SEP for losing EGHP.

I won't say for certain that your client can't get Medicare to start June 1, but yeah, he can't get Medicare to start June 1. haha There are plenty of posts about it, but I'm not going down that rabbit hole.

He did not play the game according to Medicare rules. He played it the way his financial advisor told him to play it (except for the 4/1 start date). Financial guy said enroll in Feb, 3 months before turning 65. Same guy also told him about IRMAA so he was aware of that but the 4/1 start date for A & B was not a pleasant surprise.

There have been threads where (I believe) someone may have said drop B and then re-enroll later.

I doubt that would work here.

If May 1 was his effective date he MIGHT have been able to drop B then sign up for B only this month and have it effective June 1. Given how far behind Medicare is in processing applications I doubt he can drop B and then re-enroll in hopes of saving IRMAA + B premiums for a couple of months.

He called a few days ago (when he got his Medicare card) to get advice on whether he should go with MAPD or Medigap. When I asked if he had applied for Medicare all this mess came out . . . and then he told me of a recent cancer diagnosis that may require treatment in the next month or so.

Nothing easy about this situation.

I have run into the IEP beats SEP before, so it looks like he is locked in no matter which way he turns. The only thing he MIGHT have been able to do is enroll in Part A only to be effective 4/1, and then apply for Part B in May (month he turns 65) and I think that would have made B effective in June (one month after turning 65).

Of course he didn't do it that way, so . . .

 

[wehotex]

Many people, especially seniors, don't know that your Medicare effective date can be a month before you turn 65. Someone born on May 1 discovers their Medicare coverage actually started April 1. This often does not happen until they receive their Medicare card.

Just happened with a new client who applied for Medicare a few months ago is still working, and covered by the EGHP through the end of May.

He is also subject to IRMAA.

Now he has EGHP + Medicare A&B (effective April 1) but he didn't want Medicare to start until June 1.

Unless there is a way to unwind this and start over, he is paying Part B for April & May plus IRMAA (the maximum) and doesn't want or need Medicare now.

I have a similar type working IRMAA individual who has tried to apply for Part B, but got the runaround. He T65 back in Aug 2021 already. Now, he can get Part B the regular way using the 40-B and the L-564.
Since we have already had such a delay in applying the first time, I have thought about writing "Please start Part B the 1st effective month 40 days after you start this Part B addition process" in the 40-B REMARKS section.
I'm just trying to word it so that he is not paying both the EGHP and the Part B Irmaa.
Ex: May 5 start date would net a July 1 effective date. May 20 would be an August 1, etc.
The prospect is healthy and not in a rush. IRMAA will end Jan 1 2023 in his case.

 

[LostDollar]

He did not play the game according to Medicare rules. He played it the way his financial advisor told him to play it (except for the 4/1 start date). Financial guy said enroll in Feb, 3 months before turning 65. Same guy also told him about IRMAA so he was aware of that but the 4/1 start date for A & B was not a pleasant surprise.

Caveat, not an agent.

Seems like this is still bad advice from financial guy for what his client wanted. Even if client had a May birthday other than the first, wouldn't coverage have started in May, rather than June, with a Feb sign up; still giving a one month penalty for the month of May?

Edit
edit out incorrect information
end edit

 

[LostDollar]

He could subtract some IRMAA and Part B premiums from his next financial advisor billing(s).

 

[LostDollar]

Caveat, not an agent.

I think I now see what @TwoCents is talking about.

May 1st birthday = April birth month.

IEP = Jan-Jul (And it will take precedence over employment sep)
Jan, Feb, Mar enrollment = SS April birth month effective.
Apr (SS birth month) enrollment = May month effective
No June effective
May enrollment = Jul month effective
Jun enrollment = Sep month effective
Jul enrollment = Oct month effective
Aug enrollment -- might be able to get a deemed IEP exception for Nov enrollment

Financial planner missed BOTH the 1st of month birthday iep rules AND client's desire to have PART B START 1 MONTH AFTER Planner's PERCEIVED BIRTHDAY MONTH OF MAY. Hence his client has two extra months of part B premiums and adjustments.

 

[kgmom219]

Many people, especially seniors, don't know that your Medicare effective date can be a month before you turn 65. Someone born on May 1 discovers their Medicare coverage actually started April 1. This often does not happen until they receive their Medicare card.

Just happened with a new client who applied for Medicare a few months ago is still working, and covered by the EGHP through the end of May.

He is also subject to IRMAA.

Now he has EGHP + Medicare A&B (effective April 1) but he didn't want Medicare to start until June 1.

Unless there is a way to unwind this and start over, he is paying Part B for April & May plus IRMAA (the maximum) and doesn't want or need Medicare now.

There’s no way to get June 1.
March=April
April=May
May= JULY
June=August

IMPORTANT: This changes in 2023 to first of the month after your 3rd month of IEP

Bob….can he appeal IRMAA? It will help a little bit

 

[kgmom219]

The good news is that he’s within 6 months of Part B for his Medigap.

Can he drop the employer coverage early. Is there a spouse that need’s COBRA? What’s the spouse DOB?

 

[somarco]

Bob….can he appeal IRMAA? It will help a little bit

Got that in the works. He is a pilot, retiring this month and won't have any earnings the rest of this year.

The good news is that he’s within 6 months of Part B for his Medigap.

Can he drop the employer coverage early. Is there a spouse that need’s COBRA? What’s the spouse DOB?

Employer coverage terms 5/31 . . . has claims this year (cancer) . . . dropping coverage retro a can of worms if even possible.

No job for wife . . . on his plan as dependent . . . T65 September 2022