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changes ahead

Who knew that turning 26 and turning 65 were such important milestones??? What do these ages have in common? When we reach them we are supposed to know that we are facing a major transition in our health insurance!

When we turn 26 we are automatically removed from our parents’ health insurance coverage and when we turn 65 we are generally required to check in with the authorities at Medicare. Recently it has become very clear that the insurance companies, who so willingly receive our health insurance premiums, do not necessarily feel compelled to warn us of the impending changes. In fact, we have recently discovered that 26 year olds are being dropped from their parental coverage without notification, even after the fact.

Sadly, the rules for removal are not the same. Individuals who turn 26 are dropped from parental coverage at the end of the month in which they turn 26. Seniors, on the other hand, are eligible for Medicare on the first day of the month in which they turn 65, unless their birthday happens to be on the first of the month. In that case, individuals are supposed to know that their eligibility date is actually the first day of the month preceding their birth month.

With few exceptions the termination of coverage for 26 year olds is consistent. On the other hand, the rules for Medicare enrollment for 65 year olds are quite varied beginning with what coverage was in effect pre-65. If an individual has health insurance coverage through an employer group (not retiree coverage) Medicare enrollment can possibly be postponed. If not, the rules for late entry are confusing and not favorable.

I can think of no other area of our lives in which we are expected to know the details for a single life event in this way. Health insurance is something that most of us take for granted assuming that we are covered and that the benefits we are paying for will cover the claims we incur. Beyond that we do not think about it until we need to use it.

The rules of engagement change regularly and it is incumbent upon us to remain vigilant of these changes to be sure that coverage is in effect when we need to use it. It is our responsibility to stay informed because what we are not aware of can hurt us. As they say, the devil is in the details.

If you need assistance in navigating the path, call us at Czajkowski Dumpel & Associates, Inc. – We are here to help!