Get Help With Your Healthcare Costs

January 24, 2015 Blog Article

You may qualify for help with your premiums, deductibles, copayments, or prescription costs with Extra Help or with a Medicare Savings Program.

Medicare has 4 savings programs that can help with your healthcare costs:

Qualified Medicare Beneficiary (QMB) Program (also known as the Medicare Buy-in)

Individual monthly income limit* – $1,001

Married couple monthly income limit* – $1,348

Program helps pay for: Part A premiums, Part B premiums, Deductibles, coinsurance, and copayments

Specified Low-Income Medicare Beneficiary (SLMB)

Individual monthly income limit* – $1,197

Married couple monthly income limit* – $1,613

Program helps pay for: Part B premiums only

Qualified Individual (QI) Program

Individual monthly income limit* – $1,345

Married couple monthly income limit* – $1,813

Program helps pay for: Part B premiums only

Qualified Disabled and Working Individuals (QDWI)

Individual monthly income limit* – $1,962

Married couple monthly income limit* – $2,655

Program helps pay for: Part A premiums only

Save on Drug Costs

If you have limited income and resources, you may also qualify for “Extra Help” to help pay your Medicare prescription drug costs, like premiums, deductibles, and co-payments.

In 2015, drug costs for most people who qualify are no more than $2.65 for each generic/$6.60 for each brand-name covered drug. Other people pay only a portion of their Medicare drug plan premiums and deductibles based on their income level.

In 2015, you may qualify if you have up to $17,505 in yearly income ($23,595 for a married couple) and up to $13,440 in resources ($26,860 for a married couple).

If you don’t qualify for Extra Help, your state may have programs that can help pay your prescription drug costs. Contact your State Medical Assistance (Medicaid) office or your State Health Insurance Assistance Program (SHIP) for more information. Remember, you can reapply for Extra Help at any time if your income and resources change. (To apply online follow the link at the end of this article.)

Countable resources include:

Money in a checking or savings account
Stocks
Bonds

Countable resources don’t include:

Your home
One car
Burial plot
Up to $1,500 for burial expenses if you have put that money aside
Furniture
Other household and personal items

Apply for Extra Help – Contact Social Security.

Find out if you qualify for a Medicare Savings Program. You can apply online or visit your local State Health Insurance Program. Call Social Security toll-free at: 1-800-772-1213 or TTY 1-800-325-0778, Monday-Friday 7am-7pm

Would you like my help?

If you would like to talk to me, ask a question or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message. The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available. I am paid by the insurance companies in the form of a commission if you enroll in a plan. You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.

“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”

*Medicare Savings Program Income Limits are for 2015 (2016 amounts are released in March).

QMB Quimby

Turning 65 and still working?

January 14, 2015 Blog Article, Medicare, Part D Prescription Drug Coverage, Top Posts

Should I apply for Medicare even though I have insurance at work?

Yes. If you’re not retiring and you are continuing to work then you may want to consider enrolling in Medicare Part A and delaying Part B until you retire and leave your employer sponsored health insurance plan. Even if you’re not receiving Social Security benefits at age 65, you’re still eligible for full Medicare benefits. This includes the Part A (hospitalization), as well as Part B (doctors’ visits and outpatient care) and Part D (prescription drugs); you pay a premium for each. But if you are not collecting social security benefits then it’s up to you to contact Social Security to sign up for Medicare only. You must do this within your “initial enrollment period.” This period starts three months BEFORE the month you turn 65, includes the month you turn 65 and continues three months AFTER that — a seven-month period.

Do you have an HSA?

If you enroll in Medicare Part A and/or B you can no longer contribute to your Health Savings Account (HSA). Whether you should delay enrollment in Medicare so you can continue contributing to your HSA depends on your circumstances. Carefully weigh the savings of enrolling in Medicare against the advantages of continuing to save money in a tax-free HSA.

You don’t have to enroll in all parts of Medicare.

Only the parts you need.

In a situation where you are still working at age 65 and have health insurance through your employer you don’t have to enroll in all parts of Medicare until you retire. If you have creditable insurance coverage through an employer plan, you can apply for Part A only. Part A might help pay for some of the costs not covered by your group plan such as your deductible if you go into the hospital for a surgery or if you need to stay in a skilled nursing facility. And as long as you have group coverage, you won’t be penalized for delaying Part B or Part D (Medicare Prescription Drug Coverage). When your employment or group coverage ends, you then have eight months in which to sign up for Part B and enroll in a Medicare Supplement or a Medicare Advantage plan. This is where I come in! There are a lot of different plans available and finding a plan that covers your doctors and your specific medications at the best price is what I do best. I’ve helped hundreds of people find the right plan and saved THOUSANDS in the process.

Your decision to enroll in Medicare Part B if you are still working is really a cost/value decision. The standard monthly premium for Part B is $121.80 in 2016. Where as Part A in most cases has no monthly premium. So your decision to enroll in Part B while you’re still working might depend on how much money you’re making and what your current costs are with your employer health insurance plan. You also need to consider what you’re getting. If you work for a company with 20 or more employees, your group health plan is still the primary payer of your medical bills, making your Medicare benefits of limited value. However, if your company has fewer than 20 employees, Medicare would be the primary payer and your company’s plan the secondary payer. In this case, it’s best to talk to your employee benefits administrator to see how Medicare would work with your insurance. The Part B coverage may well be worth the monthly premium.

What if I retire and then go back to work?

It’s not unheard of for insurance needs to change as people move in and out of the work force. So what happens if you retire, enroll in Part B and then find yourself back at work with employer coverage once again?

In this situation, you can drop Part B while working and re-enroll at any time while you have group coverage or during the eight months after your employer coverage ends, without risk of penalty or higher premiums.

For now, I suggest you mark the dates of your initial enrollment period on your calendar.

Then when the time comes, call the Social Security Administration at 800-772-1213 to sign up for Medicare Part A and/or Part B. You can also go to www.ssa.gov for more information.

No matter how long you choose to work, there’s no reason not to take advantage of the benefits you’ve earned. Keep in mind, this information is no substitute for an individualized consultation. You can Contact Me to schedule an appointment and we can sit down and talk about your individual needs and answer any of your questions. There is no cost or obligation to talk or meet with me. I would be glad to talk to you and answer questions about your options. You can reach me toll free at (866) 976-9038 or CLICK HERE if you would prefer e-mail. I am looking forward to answering your questions and helping you get the coverage that you need.

-Todd 🙂

Missed the deadline? You have options!

December 29, 2014 Blog Article, Medicare, Part D Prescription Drug Coverage

Did you Miss the December 7th Medicare Annual Open Enrollment Deadline?

Don’t worry, you still have options!

Special Enrollment Periods (or SEPs) allow you to change to another Medicare Part D Prescription Drug or Medicare Part C Advantage plan outside of the annual Open Enrollment Period (from October 15th to December 7th). SEPs are only granted for specific reasons (such as when you move outside of your plan’s service area, qualify for low income assistance in your state or a plethora of other reasons)

One Special Enrollment Period that is available is the 5-star SEP.

If a plan is available in your area, you can use the 5-star Special Enrollment Period for a once-a-year opportunity to switch from your current Medicare plan to a Medicare plan with a “5-star” quality rating. The 5-star SEP is available to you at any time during the plan year. So, if you discover that your plan has changed significantly in January, you are not stuck with it until next year. You can change plans today.

Who is eligible for this SEP?

Beneficiaries currently enrolled any MA, MAPD or PDP plan (including those that already have a 5-star rating)
Beneficiaries who are enrolled in Original Medicare and meet the eligibility requirements for Medicare Advantage

Effective dates for enrollments made under the 5-star SEP will be the first of the month following the month the enrollment request is received. Once you enroll in a 5-star plan using this SEP, the individual’s SEP ends for that plan year and the individual will be limited to making changes only during other applicable election periods. To summarize, the 5-star rating SEP can only be used one time during the plan year.

For more information you can visit the official Medicare website at Medicare.gov.

Please call today while your questions are fresh in your mind. There will never be any cost to you for my assistance or for a friendly, no-obligation chat.

You can reach me toll free at (866) 976-9038 or

CLICK HERE if you would prefer e-mail. I am looking forward to helping you move to a better plan to get the coverage that you need.

Will your Drugs cost more in 2015?

November 22, 2014 Blog Article, Medicare, Part D Prescription Drug Coverage

If you’re currently enrolled in Medicare, what you do or don’t do over the next few weeks could determine whether you can get the best, most affordable coverage next year. Hear’s why:

Medicare Part D prescription plans frequently change premiums, drug formularies, deductibles and co-payment amounts for specific drugs from year to year. Medicare Advantage plans often make similar changes; plus doctors, hospitals and pharmacies may drop out of their preferred provider networks.

Thus, by simply choosing the same options for 2015 without investigating alternatives, you could wind up paying hundreds or thousands of dollars more for similar healthcare services.

Medicare’s annual election period ends Dec. 7.

For most people, this is the best — and sometimes only — opportunity to make coverage changes. (Exceptions are made for people who qualify for special enrollment periods.)

If you already have traditional Medicare Parts A and B and a Medigap plan, you don’t need to make any changes; however, if you also have a Part D plan, you must either accept your current plan’s changes or choose another plan.

When choosing next year’s Part D plan:

Carefully review your plan’s “Annual Notice of Change” for any changes to premiums, deductibles, co-payments, covered drugs, participating pharmacies, etc.
Notice whether they’ve changed co-payments or co-insurance for your medications or possibly dropped some altogether. (Yes, this does happen!) Ask your doctor whether comparable, covered drugs will work; otherwise you could pay much more next year.
Even if your plan hasn’t changed substantially, it’s still wise to sit down with someone like myself who can help you compare all available plans. Each year I am trained and tested on the new plans by each of the insurance companies and I have the experience and knowledge to help you make the best choice.

IMPORTANT NOTE: The lowest monthly premium may not be your best bet — sometimes plans with higher monthly premiums have a lower overall cost due to their more favorable deductible, co-payment and coinsurance amounts. Also each company negotiates individual drug prices so a drug that costs $400 per month with one company may put you in the Coverage gap sooner than one that only costs $80 with another company. This is an important piece of your plan review.

Medicare Advantage plans are HMO or PPO type Managed care plans. They are alternatives to Traditional Medicare Parts A and B with a Medigap Supplement. Most cover drugs and some include extra benefits like vision and dental coverage or reimbursement for gym memberships. They usually have lower deductibles and co-payments but require you to use the plan’s provider network.

If your Part C, Medicare Advantage plan includes drug coverage you should also carefully review the “Annual Notice of Change” from your plan for any changes that could cost you more money in 2015.

Bottom line: Reviewing your Medicare options each year is complicated and time-consuming. But if you don’t and your plans change significantly, it could cost you a bundle next year.

Call Todd today for a no-cost plan review, toll free: (866) 976-9038

When do I enroll in Medicare?

November 16, 2014 Blog Article, Medicare, Part D Prescription Drug Coverage, Top Posts

When you're approaching age 65, it's important to thoroughly research the benefits and costs of each different Medicare insurance plan in your area. But it's even more important to make sure you enroll at the right time.

Missing an enrollment date could cost you higher premiums down the line or it could cost you coverage entirely.

If you are already receiving Social Security or Railroad Retirement Board benefits when you become eligible for Medicare you won't have to worry about your enrollment date, since the government automatically enrolls you in both Part A and Part B at age 65. (Three months prior to your 65th birthday, your Medicare card will arrive in the mail.) Your only concern of timing would be if you declined Medicare Part B (and missed the initial enrollment window). If you do decline Part B, you will pay higher Part B premiums if you enroll later on. For each year that you don't enroll your premium will be 10 percent higher, unless you're insured by an employer-sponsored health insurance through either you or your spouse.

If you are not receiving Social Security or Railroad Retirement Benefits when you become eligible for Medicare you won't be automatically enrolled in Original Medicare. Instead, you'll be able to enroll during one of three enrollment periods.

Initial Enrollment Period – a seven-month window of time that begins three months prior to the month of your 65th birthday. The date your Part B coverage starts depends upon how early in the IEP you enroll. If you wait until the last four months of the IEP, the start date of your coverage will be later.
General Enrollment Period – January 1 to March 31 of each year. Your coverage will begin on July 1 of the year you enroll.
Special Enrollment Period – You can wait to enroll in Part B and not incur a premium hike if you had coverage through your job or your spouse's job at the time you became eligible for Medicare. While you're still covered, you can enroll in Medicare at any time – and for another eight months after you lose your group coverage or you (or your spouse) stop working.

For more information about signing up in Parts A and B you can contact your local Social Security office or call 1-800-772-1213. If you would like to know more or talk about your options and what plans are available for you, call me at (207) 370-0143. There is never any cost or obligation to discuss your options.

Once you have enrolled in Parts A & B you may need to enroll in a Medicare Part D prescription drug plan – even if you do not take any medications!

With Medicare's prescription drug coverage, your first opportunity to enroll is when you're first eligible for Medicare (during the seven-month period beginning three months before your 65th birthday). It's important to note that if you don't enroll during the seven-month period when you're first eligible, you may pay a late-enrollment penalty that will raise your Part D premium when you do decide to purchase coverage.

During the Open Enrollment Period mentioned above, you can also enroll in a Medicare Part D plan, switch to another Part D plan or leave Part D entirely. Again, pay close attention to the dates as they affect your options.

Between October 15 and December 7 – You can join a Part D plan, switch between Part D plans or drop your Part D coverage.
Between January 1 and February 14 – You can leave Original Medicare for an Advantage plan that offers prescription drug coverage. You can not switch from one Part D plan to another.

There is still much more you should know but these are some important dates to keep in mind. For more information about late enrollment penalties or to ask some specific questions you can call me anytime toll free at (866) 976-9038 or use my Contact Me form on this website to email me. 🙂

Why everyone needs professional help.

November 7, 2014 Blog Article

Cutting out the middle-man isn’t always a good thing.

Why You Need An Insurance Agent

It still shocks me when someone asks why they should use an agent instead of just calling the insurance company directly to enroll in a Health Insurance Plan. But I understand why you might ask this question. If you get something in the mail and it looks like a good deal then why not just cut out the middle man and buy direct?

The answer is simple. Because you need the advice and guidance of someone who is trained and experienced.

Who’s watching out for you?

When you call an insurance company they will only tell you why their plan is better than the others. They will not tell you what the competition may offer because their job is to sell their plan and only their plan. Also when they sell direct to you without an agent they increase their profits because they no longer have to pay a commission to an agent. This money does not get passed on to you. It stays in their pockets or gets paid out to their stockholders.

Your health insurance costs will not be any higher if you choose to work with an agent or if you choose to work directly with the insurance company. But it may cost you more in the long run if you choose not to talk with an agent. By going direct you might not learn about the plan that has a lower cost prescription copayment for an expensive brand name drug you take or the one that offers to pay for your vitamins or other health and wellness products.

There are many benefits to working with an agent.

In my opinion the most valuable benefit to working with an agent is your relationship with your agent. When you have a question or need to help making a change you have someone to call who is knowledgeable and has experience to offer you solid advice. Someone who cares about maintaining a relationship with you and wants to help you.

Additionally, Independent Agents like myself are trained and tested annually on ALL the health insurance plans we represent. We know what these plans cover and how they cover it. Agents also have first hand knowledge of customer experiences with each plan. Agents talk to their clients on a regular basis and know when their clients are unhappy with a plan and what shortcoming the plans have. The insurance company’s representative is not going to tell you about a bad customer experience but your agent will share their clients experiences with you both good and bad so you get a clear understanding of how the plan operates.

What about shopping online?

Some websites now offer a “comparison” so that you can see clearly how the different plans look “side-by-side.” These comparisons only show you the basic costs. They do not show you additional benefits offered such as dental, vision and hearing. Each plan is unique and has its strengths and weaknesses. Agents familiar with these plans know what those are and can assist you in making a better decision.

A typical meeting with an agent starts out with a conversation about your needs. I will ask basic questions to determine what your needs are and when we are through I will show you which plans cover your specific needs. Then you review these plans with your agent and you ask questions YOU will learn more about the plans so YOU can make the decision as to which plan is right for you. A good agent is a resource. Someone who has the knowledge and experience to help guide you in making a good decision and is there by your side every step of the way through the enrollment process and still available afterwards to answer any questions that come up.

Would you like my help?

If you would like help finding the right dental plan or ask a few questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message. The best part about working with me is that it will not cost you anything to talk with me to discuss your options and review the plans that are available. I am paid by the insurance companies in the form of a commission when you enroll in a plan. You will not pay anything to meet with me and you will pay the same price for your insurance that everyone pays whether they had my help or not.

“My goal is to help people and I have found great joy in being able to offer my services to people who need my help.”

Are you turning 65 and still working? Read this.

Part B Premium stays at $104.90 for 2015

October 9, 2014 Blog Article

Good news! Medicare Part B Premium will NOT increase for 2015!

U.S. Department of Health & Human Services News Division announced today that the Part B premiums and deductibles for 2015 are to remain the same as the last two years! Also, premiums, copays and deductibles for other Medicare programs for 2015 were announced. CMS released a new bulletin today that can be read in its entirety be clicking on the link below.

http://goo.gl/RIjDdF

6 Reasons To Change Your Medicare Plan.

October 3, 2014 Blog Article, Medicare, Part D Prescription Drug Coverage

6 Reasons To Change Your Medicare Plan.

1. Has your health situation changed?

Perhaps you have developed a health condition in the previous 12 months that requires a new prescription drug or ongoing visits to a specialist. It’s important to know whether the plan you have, or decide to purchase, covers these health needs.

2. Have you changed doctors?

Physicians may retire or relocate, and medical facilities may change their terms. A number of developments could lead your plans to no longer include the doctors you see or the medical center you visit. If your doctor is important to you, this is a good reason to study your options and possibly switch Medicare plans.

3. Has your coverage changed?

Plans can alter the drugs, procedures and conditions they cover. For example, your prescription drug Part D plan may no longer cover the prescription drugs you need to purchase in the coming year, or put restrictions on how and where you purchase them. Questions about prescription drug costs are one of the top concerns I encounter. This is especially critical for those who fall into the prescription drug donut hole. The donut hole is the gap of coverage in which the individual pays a greater percentage of the drug cost.

4. Have your plan premiums, co-pays or deductibles increased?

Price changes occur year to year, so examine the prices you have been paying and what you can expect to pay in the coming year. There may be alternative plans with lower costs available in your area that an experienced Agent like myself can help you review.

5. Have you moved or are you planning to move?

It’s important to consider your Medicare plans when moving because you may leave the plan’s service area and be disenrolled or have new options available to you.

6. Has your current plan changed dramatically or will it no longer be available next year?

In these instances, beneficiaries should take the time to talk with an agent to review their options. Sometimes plans are eliminated because the provider offers a similar plan, but it’s still important to compare that coverage to what you actually need in the coming year.

The Bottom Line.

It is always a good idea to call your agent and have a brief conversation to discuss how your current plan is meeting your needs. If you are happy with your current plan and all your doctors and medications are covered by the plan that’s great. But if a new doctor you want to see does not accept your plan or the plan will not pay for those visits or if you are prescribed a new medication that is not covered then you should most certainly check to see if there is another plan available that will give you the coverage you need. Maine has a lot of Medicare Supplement and Medicare Advantage plans available to choose from. I talk to every one of my clients each year to review any plan changes and to make sure they are receiving the coverage they need.

Each year, Medicare open enrollment brings with it changes that can affect you. The limited enrollment timeframe of just 54 days – Oct. 15 to Dec. 7 – gives all Medicare beneficiaries the opportunity to change their Medicare plans for the coming year to better match their needs and potentially save on health care costs. This includes anyone using original Medicare, Medicare Advantage or Part D prescription drug plans.

In the fall, Medicare participants receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their current Medicare Advantage and Part D providers. It’s important you read this information. Take time to review your current health care needs, and then compare this to the plan’s coverage for the coming year. Reviewing your Medicare plan options earlier rather than later will put you in a better position to make changes during the annual enrollment window.

I hope you found this information helpful.

Does Open Enrollment matter to me if I am happy with my current Medicare plan?

September 20, 2014 Blog Article, Medicare, Part D Prescription Drug Coverage

You are happy with the plan you have today….

However, as of January 1, a new plan will take effect that you’ll have to live with in 2015. Here are some of the things that may change:

Your monthly premium
Your annual deductible
Your annual out-of-pocket spending limit
Your out-of-pocket costs (co-payments or coinsurance)
The network of providers and pharmacies
The drug formulary (list of medications the plan covers)
Coverage rule for medications (quantity limits, step therapy, prior authorization requirements)

How will I know what is changing?

Prior to October 1st your Medicare Advantage or your Part D drug plan must send information about changes in benefits and costs for the upcoming calendar year. You will be receiving this Annual Notice of Change (ANOC) in the next few weeks. Take time to study it.

If you have concerns, you can use the Medicare Plan Finder at www.Medicare.gov to compare plans in your area or by talking to an insurance broker or agent who is contracted with your plan and can help you understand all the changes. If you don’t like what you find, use the Plan Finder to check out other plans and if your agent is contracted with those other plans he/she will be able to help you change to the new plan that better suits your needs for the coming year. The new plan will take effect January 1st.

Do ALL agents and brokers know about ALL the plans available?

If your agent is not contracted with one of the plans you are interested in this means they have not been trained by the insurance company and may give you wrong information about the plan based on rumors or out-dated information which could end up costing you.

I am a licensed insurance agent in Maine and New Hampshire. I specialize in educating people on all the Medicare supplements and Medicare Advantage Plans offered in Maine and New Hampshire. I am an independent agent which means I do not work for one specific insurance company. I have contracts with many different insurance companies and I am trained annually and have passed exams to be able to offer those plans to my clients. The benefit to you is that I am a “one stop shop.” When my clients sit down with me, I review their needs and match them up with all the plans available and then I am able to help them narrow down those choices to one plan. I will help you enroll in the plan that is best for you and I will be there for you during the year if you have any questions or need help. I also meet with my clients each year before the plans change to review those changes and when necessary help them to find a plan that suits their needs better at that time.

I am currently contracted with the following insurance carriers;

Aetna
Anthem/Blue Cross Blue Shield
Harvard Pilgrim Health Care
Humana
Martin’s Point Generations Advantage
Maine Community Health Options
Todays Options
Universal American (Today’s Options)
Wellcare
and Delta Dental

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the Contact Me page here to send me an email message. It will cost you nothing to meet with me to discuss your options or the plans that are available. I am paid a commission by the insurance company when you enroll in the plan. I am looking forward to helping you find the plan that right for you. Please contact me today to set up a time to talk.

Thank you.

How to Sign Up for Medicare

September 16, 2014 Blog Article, Medicare, Part D Prescription Drug Coverage

So you’re turning 65? Congratulations!

It’s time to start taking advantage of your Medicare benefits. And just how do you do that?

First, here’s a quick overview of what Medicare offers:

Medicare has 4 parts; A, B, C, & D. Part A pays for hospitalization, and most eligible people do not pay premiums for Part A. Part B covers doctor fees, outpatient care, home health care, and preventive screenings for Cancer, Glaucoma, Diabetes, and other diseases. Part B has a monthly premium, which for most beneficiaries is $104.90 this year. Part C is Medicare managed care and Part D is prescription drug coverage. Both of these options are available through private insurance companies.

If you already get benefits from Social Security or the Railroad Retirement Board(RRB), you will automatically be enrolled in Part A and Part B starting the first day of the month you turn 65. You’ll get your red, white, and blue Medicare card in the mail about three months before your 65th birthday. If you don’t want Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you’ll keep Part B and pay your Part B premiums which will be deducted from your Social Security Check each month.

If you are not currently receiving Social Security or RRB benefits (because, for instance, you’re still working), you need to sign up for Part A and/or Part B. It’s easy to do. You can sign up by calling Social Security at 1-800-772-1213 or by calling your local Social Security Office. You can also apply online for Part A (if you don’t have to pay premiums) and Part B at www.socialsecurity.gov/medicare. The whole process can take less than 15 minutes for most people.

If you’re eligible for Part B when you turn 65, you have a seven-month window that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. Sign up early! That way you’ll avoid any delay in getting your benefits. If you sign up during the first three months of your Initial Enrollment Period, in most cases your coverage starts the first day of your birth month. (If your birthday is on the first day of the month, your coverage starts on the first day of the month before.)

If you didn’t enroll in Part A and/or Part B when you were first eligible because you were working and covered under a group health insurance, you have a Special Enrollment Period (SEP). This means you can sign up any time while you or your spouse are working and you have employer or union group coverage. Or you can enroll during the eight-month period that begins after your employment ends or your group health coverage ends, whichever happens first. With part C Medicare Advantage plans you only have the 3 months prior to when your Part B starts. For example, if your Part B Medicare benefit starts on January 1 then you can enroll starting October 1.

Generally, you won’t pay the Late Enrollment Penalty if you sign up during your a Special Enrollment Period.

But here’s an important caveat: If you have COBRA coverage or a retiree health plan, you don’t have coverage based on current employment. You’re not eligible for a Special Enrollment Period when that coverage ends AND you may be subject to the Late Enrollment Penalty.

For more information about enrolling in Medicare, visit www.medicare.gov or my calling 1-800-MEDICARE (1-800-633-4227).

I am a licensed insurance agent in Maine and I am happy to help explain this process and answer any of your questions. I can also help you review the many supplemental insurance plans available in your area and give you the advice that you should have to choose the right plan for you and your spouse. Call me anytime. My number is 207-370-0143 or send me a message using my contact page and I will respond by email or call you, which ever you prefer. Good luck and welcome to Medicare!

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