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Already Enrolled In Medicare
If you are already enrolled in Medicare, annual Open Enrollment will be October 15 through December 7. Review of drug plans and Medicare Advantage plans is critical every year. Enrolling in or remaining in the wrong plan can have significant financial impact. Enrolling in the most appropriate plan, but filling prescriptions at the wrong pharmacy can also take quite a toll on the family checkbook. Using preferred vs. non-participating pharmacies can bring the annual out of pocket cost down significantly. A quick review each year may pay rewards far beyond what you can imagine.
Not Yet Enrolled In Medicare
If you have not yet enrolled in Medicare there are many details for you to consider. We at CDA, Inc. have created a consulting package that will help educate prospective enrollees on the options and requirements related to Medicare. As a Medicare-eligible individual, you will be provided, first, with a PDF “Guide” of critical information about the Medicare program; then, a video of detailed information so you are able to make well-informed decisions. We follow up with a consulting conversation with a senior broker to answer your questions and provide guidance that is relevant to your specific situation. We will also help with enrollment in Medicare, deciding between Medicare supplement and Medicare Advantage options and assessing your drug plan choices.
We Are Here To Help
Who is eligible to enroll, who needs to enroll , who should think carefully about enrolling in Medicare? We counsel our clients’ employees on their Medicare options and requirements. We protect our clients from unnecessary risk relative to employees who are covered on an employer plan while they are eligible for Medicare coverage.
I’m still working and I am on my employer medical plan…when do I need to sign up for Medicare A/B?
For employees of firms that employ less than 20 employees, Medicare parts A & B are required as Medicare coverage is primary and the commercial insurance carrier is only be responsible for charges that exceed that coverage. For employees of firms that employ 20 or more employees, there is a chance that enrollment in Medicare will be unnecessary, and may even be discouraged. The employer group plan for these larger plans will be the primary carrier so enrolling in Medicare will be redundant. If employees in this category elect to enroll in Medicare they should NOT enroll in Medicare part B as there are a series of other complications which could come up later.
How much of a window do I have before penalties apply and what are those penalties?
If individuals do not enroll within the enrollment window around their 65th birthdays, or have credible coverage through an employer of 20 or more employees, late penalties will apply.
Will I be fine with just Medicare or do I need other coverage (Medicare Supplement/Medicare Advantage)?
It is always in an individual’s best interest to compare the benefits of a Medicare supplement plan to a Medicare Advantage plan. Considering options of continuing any coverage available through employment that extends beyond age 65 or available through the VA is also critical. We at CDA, Inc. offer an educational consult which can help compare the various options available to individuals as they become eligible for Medicare and beyond.
If I retire before age 65 am I eligible for Medicare?
Unless an individual qualifies for Medicare as the result of a disability, end stage renal disease or ALS, eligibility begins at age 65.
Will I be subject to medical underwriting?
If enrollment is done on a timely basis there will be no medical underwriting for the Medicare supplement. Enrollment for Medicare parts A, B and C, never includes medical questions.
Which is preferred – home health care or nursing home care?
Home Health Care and many other skilled nursing costs are covered under Medicare. Unskilled care, as is often provided in a nursing home, is typically not covered by Medicare.
How can I use Medicare while traveling inside the continental US?
A Medicare beneficiary can access care from any provider in the United States. Those providers who accept Medicare assignment will be reimbursed directly by Medicare. An individual will need to pay those providers who do not accept Medicare assignment directly and be reimbursed by Medicare for the amount of compensation a provider who did accept Medicare reimbursement would have been paid. Any balance of the bill will be the beneficiary’s responsibility.
What should I know about Medicare while traveling internationally?
Please remember that Medicare does NOT provide coverage when a Medicare beneficiary is travelling outside the U.S., its territories or U.S. waters. Certain Medicare supplement policies and Medicare Advantage plans help address this gap, but not all do.