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.