Frequently Asked Questions About Medicare

Medicare is a federal health insurance program that provides benefits to American citizens and permanent legal residents (of at least five continuous years) aged 65 and older, or who have a qualifying disability or illness. Most people are automatically enrolled into Original Medicare, Part A and Part B, when they become eligible; however, some people need to manually enroll in Medicare. Medicare Part A is hospital insurance; Medicare Part B is medical insurance.

This depends on your situation. If you’ve worked at least 10 years (40 quarters) under Medicare-covered employment and paid Medicare taxes during that time, you qualify for premium-free Medicare Part A and will be automatically enrolled at age 65 even if you’re still working. If your spouse has enough employment quarters, you can also qualify for premium-free Medicare Part A based on his or her work history.

Another Medicare eligibility requirement is that you need to be an American citizen or permanent legal resident of at least five continuous years.

If you don’t have enough work history to get Medicare Part A without paying a premium, you can decide to delay enrollment if you already have health coverage through an employer or union (or through your own work or your spouse’s employer). Medicare Part B always comes with a monthly premium, so you may similarly choose to delay your Part B enrollment if you or your spouse are still working and have employer-based group coverage.

Remember, if you don’t sign up for Medicare when you’re first eligible and don’t have other coverage based on current employment, you could have to pay a late-enrollment penalty later when you do enroll. The late-enrollment penalty applies to Medicare Part B (and Part A, if you have to pay a premium for it).

One factor to consider is that even if you have health coverage through your employer or union, Medicare may help pay for some of the costs not covered by your group health plan. For example, enrolling in Medicare may be useful if you work for a small company (less than 20 employees) because Medicare could be the primary payer before your group health insurance. You may want to consult with your employer or union benefits administrator for specifics on how your health coverage and costs may compare with Medicare.

If you do decide to wait until your group coverage ends to enroll in Medicare Part A and/or Part B, you’ll have an 8-month Special Enrollment Period to sign up for Medicare that starts once you stop working or your group coverage ends (whichever happens first). You can also enroll in Medicare at any time that you are still working and have employer-based coverage.

If you choose COBRA after you stop working, do not wait until your COBRA coverage ends to sign up for Medicare. If you delay enrolling in Medicare Part A and/or Part B after your Special Enrollment Period ends, you’ll have to wait until the next General Enrollment Period (January 1 to March 31 every year) to enroll, and you may have to pay a late-enrollment penalty.

Reason to use a Medicare Broker to Pick a Plan

When it comes to searching for health insurance, can - and should - we purchase it without the help of a sales professional? We can certainly benefit from the expertise of a sales agent in some situations, and a licensed Medicare insurance broker may provide invaluable guidance as we research and compare insurance plans. Healthcare coverage decisions can have serious consequences on your health and financial well-being, and a licensed insurance agent may be the knowledgeable resource that helps you and your loved ones find the quality Medicare insurance plan that is right for you, at a price you can afford.
There are distinct advantages of working with a licensed sales broker who can help guide you through the process of enrolling in Medicare insurance coverage. Consider these benefits of working with a Medicare insurance sales agent:

1. Working with a broker doesn’t cost you anything There are no fees to pay for using the services of an insurance broker. In fact, the rates offered by insurance plans already account for commissions paid to insurance brokers, so your cost will not differ whether you work with a broker or enroll on your own. Why not get the help of a knowledgeable and licensed insurance sales agent who can make the process of enrolling easier than ever?

2. Medicare expertise. If you are approaching Medicare eligibility for the first time, you may understandably feel a little overwhelmed by the amount of information available for you to sift through. While you and/or your family may have previously been covered by group insurance plans through an employer or an individual or family plan, Medicare insurance is different. It is individual insurance, but any decisions you make can affect your family. Having an expert who can help guide you through the structure, plans, benefits, and costs of Medicare can make a big difference as you explore your options.

Medicare also comes at a time when your lifestyle may be changing. Whether you have retired already or are continuing to work, you may have different priorities for your future. Your insurance sales agent can help you adjust to your Medicare options as they relate to financial planning for your retirement.

1. Greater options Independent brokers can provide you with options from an array of carriers. While contracting with different insurance companies, some insurance agents can help you compare thousands of plans from hundreds of carriers. Having a broker that contracts with different carriers helps eliminate bias as they help you research and compare. The wealth of collective data at your fingertips is essential as you search for the Medicare insurance plan that best meets your individual needs, and an independent broker can help you narrow your choices and make an informed decision.

2. Expertise Licensed sales agents in the Medicare arena go through hours and hours of training and education every year in order to sell Medicare insurance plans. Not only do they understand the parameters of your options, they have access to vital information that may help you make this very important decision. Most Medicare beneficiaries can only change their Medicare insurance coverage once a year, during the Annual Enrollment Period from October 15 through December 7, so you will likely be stuck with the insurance you choose for twelve months, unless you are eligible for a Special Enrollment Period.

3. Tailored guidance An insurance agent can help tailor your Medicare insurance options to fit your needs and preferences. Every Medicare beneficiary is unique – and you deserve to find a plan that fits into your budget and lifestyle and will give you access to the quality healthcare you deserve. Many insurance agents take on the role of personal adviser as you work together to review and compare Medicare insurance plans. Getting to know you and your healthcare coverage needs, your broker can fine-tune the search and help you enroll in the Medicare plan that will protect you and your family from stressful medical expenses.

4. Save Your Time We are all busy – and whether you are retired or not, your time is valuable. A knowledgeable broker can save you time on research and plan comparison, especially if Medicare coverage is new to you. A licensed insurance agent can help you narrow down your options efficiently, and guide you to the coverage that will fit your circumstances so that you don’t waste time with options that simply won’t meet your needs.

5. Experience matters As an industry expert, your licensed sales agent may have years of experience navigating Medicare. Knowledge is important, but an agent’s experience can help you avoid pitfalls as you explore your options. With experience in the Medicare market, your insurance agent can be your guide into Medicare terminology, policies, and processes.

6. Area specialty Local brokers can provide more detailed knowledge of the plans available in your area. They may be familiar with the network of providers and suppliers, and can help advise you in regards to the Medicare plans offered.

7. One-stop shopping Licensed sales agents may be able to offer you a one-stop shopping experience. Thanks to innovative technology, brokers can utilize software that will give you access to all the plan information you need, at any time that is convenient for you. Many offer 24/7 assistance, answers to the most frequently asked questions, and webinars regarding issues that are important to you. Without having to leave their site, you may be able to research and compare Medicare coverage options, request proposals, and even enroll in some Medicare Advantage plans.

8. Service after the sale Your relationship with your broker doesn’t end at the sale. Instead, your insurance sales agent may be an advocate for you in the years to come, helping you address concerns with your insurance coverage. A broker can help you review your healthcare coverage needs annually so that, as time goes by, you will continue to have the right plan for any changing needs.