Working After Turning 65

[beachbum2012]

Cobes is correct.

Basically, if Medicare is supposed to be your primary insurance, you need to take it or face a penalty. If you're employed by a small company that does not have a Medicare primary requirement, then you will not face the penalty. Talk to the HR department to verify the plan is set up.

Just to clarify, you're saying that if a company has less than 20 employees and does not require Medicare to be primary, there is no Part B penalty? On the other end of the spectrum, can a large company require the employee to get Part B, they don't do so, and then face a LEP after retirement?

In almost every instance when I meet with a potential client and they're still working, and I tell them to go ask HR or their benefits department if they require them to get Part B, they can never find someone that knows the answer. Even in a fairly large company that has a decent amount of employees 65+, nobody seems to know the right answer.

To further the discussion, I'm working hard this year finding good ways to automate follow-ups. What's the best way to follow up with these T65 folks you meet with that either they, or their spouse, is still working? It seems like they never retire when they plan. For example, if I meet with the T65 husband and the wife is 62, he's planning to stay on her coverage until she retires at 65. 2 things usually happen if I follow up: 1) they never pick up the phone or return my calls since they met with me almost 3 years ago, or 2) they answer and say "oh she retired a year ago."

Do you guys drip on them over these 3 years with maybe a Send Out Card every year asking if they'll be retiring soon, or possibly an automated email sent out every 6 months or so?

 

[unic.consulting]

Just to clarify, you're saying that if a company has less than 20 employees and does not require Medicare to be primary, there is no Part B penalty? On the other end of the spectrum, can a large company require the employee to get Part B, they don't do so, and then face a LEP after retirement?

In almost every instance when I meet with a potential client and they're still working, and I tell them to go ask HR or their benefits department if they require them to get Part B, they can never find someone that knows the answer. Even in a fairly large company that has a decent amount of employees 65+, nobody seems to know the right answer.

To further the discussion, I'm working hard this year finding good ways to automate follow-ups. What's the best way to follow up with these T65 folks you meet with that either they, or their spouse, is still working? It seems like they never retire when they plan. For example, if I meet with the T65 husband and the wife is 62, he's planning to stay on her coverage until she retires at 65. 2 things usually happen if I follow up: 1) they never pick up the phone or return my calls since they met with me almost 3 years ago, or 2) they answer and say "oh she retired a year ago."

Do you guys drip on them over these 3 years with maybe a Send Out Card every year asking if they'll be retiring soon, or possibly an automated email sent out every 6 months or so?

When an under-20 employer chooses an insurance plan, they can lower their costs by requiring 65+ employees to have Medicare as a primary or even to automatically drop coverage at 65. The employer plan is therefore not creditable for employees over 65.

For large employers, Medicare rules state that the company must be primary and Medicare secondary. Since Medicare is not primary, there is no penalty for not signing up.

If no one in HR knows the answer, they should contact their rep with the insurance company. They will have the answer.

As for keeping in touch, I tend to reach out to them every year at open enrollment to make sure they are receiving all of the care they need. If they talk about expensive prescriptions or medical bills, I remind them about the options they have available.

 

[WCMason]

Just to clarify, you're saying that if a company has less than 20 employees and does not require Medicare to be primary, there is no Part B penalty? On the other end of the spectrum, can a large company require the employee to get Part B, they don't do so, and then face a LEP after retirement?

The number of employees has nothing to do with whether someone does or does not get a late enrollment penalty for Part B. It only determines whether Medicare is primary or secondary.

 

[yorkriver1]

I am confused about this, and not sure where to get clear. Have we worked that out?

How can an employer on a group under 20 choose whether or not to have Medicare be primary? I have been told, but have not 100% confirmed that one carrier I rep will let the employer decide, and will pay primary unless employer has employees sign up for Medicare B. The other carrier makes the employer accept that employees had best enroll, since claims will be paid as if Medicare is primary on their groups under 20.

Rules for over 20 seem much more clear.

 

[WCMason]

I am confused about this, and not sure where to get clear. Have we worked that out? How can an employer on a group under 20 choose whether or not to have Medicare be primary? I have been told, but have not 100% confirmed that one carrier I rep will let the employer decide, and will pay primary unless employer has employees sign up for Medicare B. The other carrier makes the employer accept that employees had best enroll, since claims will be paid as if Medicare is primary on their groups under 20. Rules for over 20 seem much more clear.

An employer with less than 20 employees on payroll does not get to decide whether Medicare is primary or secondary. Medicare's Second Payer rules determine whether Medicare is primary or secondary.

Here is a good publication on it: Who Pays First?
https://www.medicare.gov/Pubs/pdf/02179.pdf

 

[BeeSelective]

Part A is not free, you pay for it while working.
Part A is automatic at age 65

 

[WCMason]

Part A is not free, you pay for it while working. Part A is automatic at age 65

One does pay for Part A while working or by being married to someone who paid enough Social Security credits through earnings, but it is still called Premium Free Part A.

It is only automatic for those who are receiving Social Security benefits. Otherwise it is not automatic and one must apply for it to get it and should not apply for it if they are still working and covered by an employer group health plan that has a health savings account.

 

[Matthew King]

Just for further clarification on what WCMason said:

Some people get Part A and Part B automatically (not everyone)

If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65.

(If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.)

If you’re under 65 and disabled, you’ll automatically get Part Aand Part B after you get disability benefits from Social Securityor certain disability benefits from the RRB for 24 months.

If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you’ll get Part A and Part B automatically the month your Social Security disability benefits begin.

If you’re automatically enrolled, you’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or 25th month of disability
benefits.

If you do nothing, you’ll keep Part B and will pay Part B premiums. You can choose not to keep Part B, but you may have to wait to enroll and pay a penalty for as long as you have Part B.

Some people have to sign up for Part A and/or Part B (not everyone)

If you’re close to 65, but not getting Social Security or Railroad Retirement Board (RRB) benefits, you’ll need to sign up. Contact Social Security 3 months before you turn 65.

You can also apply for Part A and Part B at socialsecurity.gov/retirement. If you worked for a railroad, contact the RRB. In most cases, if you don’t sign up for Part B when you’re first eligible, you may have to pay a late
enrollment penalty for as long as you have Part B.

If you have End-Stage Renal Disease (ESRD) and you want Medicare, you’ll need to sign up. Contact Social Security to find out when and how to sign up for Part A and Part B.

If you live in Puerto Rico and get benefits from Social Security or the RRB, you’ll automatically get Part A the first day of the month you turn 65 or after you get disability benefits for 24 months.

However, if you want Part B, you’ll need to sign up for it by completing an “Application for Enrollment in Part B Form” (CMS-40B). If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B.

If you reference pages 23-24 in the Medicare & You handbook. It very clearly states the above.

https://www.medicare.gov/Pubs/pdf/10050.pdf

 

[LewB]

So to clarify everything, if you are turning 65 and there are 20 or less employees and Medicare pays first you need to sign up for part A & B or your employers insurance may not pay anything.

Once you retire you have 63 days to enroll in a Med Supp and you have guarantee issue rights. (plan A, B, C, F, K, or L)

 

[WCMason]

So to clarify everything, if you are turning 65 and there are 20 or less employees and Medicare pays first you need to sign up for part A & B or your employers insurance may not pay anything. Once you retire you have 63 days to enroll in a Med Supp and you have guarantee issue rights. (plan A, B, C, F, K, or L)

At retirement a person gets the full six months Open Enrollment to get their Medicare supplement if they delayed Part B until the retirement, which is what most people do. The G.I. would only apply if they took Part B more than six months before their retirement.