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How to Enroll in Medicare Part B – whether you are just turning 65 or have worked past 65

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If you are self-employed or retired when you turn 65, signing up for Medicare Part B is a very simple process. You simply go to the Social Security website, www.ssa.gov, and do it on-line. Medicare allows you to enroll in Part B the 3 months before your birthday, the month of your birthday and 3 months after your birthday. This time period is called your Initial Enrollment Period. To ensure they have their Medicare cards as soon as possible I encourage my clients to go on-line to enroll in Part B during the month they are first eligible to apply. Individuals who receive their Social Security checks before 65 are automatically enrolled in Medicare Part B.

Unless your annual income is higher than $80,000 as a single person or $170,000 as a married couple, you will pay $135.50 per month for Part B. If your income is higher than these amounts you will pay more. Unless you are fortunate enough to have worked for a company or government agency which provides lifetime health benefits, your choices are either a Medicare Advantage plan with drug coverage or a Medicare Supplement and drug plan. Either choice is protection against unlimited medical expenses. To enroll in a Medicare Supplement or Advantage plan you are required to be enrolled in both Medicare Part A and B.

Often people work past 65 (or have a spouse who is working) for a company with 20 or more employees that provides them with health insurance without enrolling in Part B. When these benefits are lost due to retirement, death of a spouse, divorce or layoff, signing up for Part B is more complicated if you are past the Initial Enrollment Period. Any of these scenarios are considered a SEP (Special Election Period). In this type of SEP one must fill out a paper application for Medicare Part B, and Section A of the Request for Employment Information form. Your (or your spouse’s) employer must complete Section B of this form. The Request of Employment Information form Section B is needed to confirm you have had credible health insurance coverage during your employment. This is an important part of the process which will prevent you from being penalized for not enrolling in Part B when you first turned 65.

These forms can be found at your nearest Social Security office or going to their website, www.ssa.gov. Once completed they should be mailed or hand carried to the nearest social security office. For additional information contact Social Security at 1-800-772-1213.

Why enrolling in COBRA can be a costly Medicare mistake

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If you (or your spouse) lose or quit your job with health insurance when you are eligible for Medicare it is unlikely COBRA (Consolidated Omnibus Budget Reconciliation Act) will be your best choice for health insurance. Medicare does not recognize COBRA as creditable coverage as they do group health insurance.  Medicare eligible individuals have 8 months to sign up for Medicare Part B once they lose their group health insurance. However, if one chooses COBRA instead and stays on it 18 months, they will be required to enroll in Part B between January 1st and March 31st. To make matters worse their Part B coverage will not begin until July 1st. Since you are not allowed to buy a Medicare Supplement or Advantage Plan without Part B, it means they will go several months with only Part A (hospital) coverage. Read More

Are you paying a penalty for not having health insurance?

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If  you have gone 3 months or longer without  ACA (Affordable Care Act) compliant health insurance in 2018 you may have to pay a penalty when you  file your 2018 taxes. No penalty for having health insurance does not kick in until 2019. The penalty is $695 per adult or 2.5% of household income, whichever is greater.

Save on Fertility Services if you have a BlueCross BlueShield of North Carolina policy

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BlueCross BlueShield of North Carolina (BCBSNC) now offers discounts on fertility services through a partnership with WINFertility. The highlights include 10% to 40% savings on fertility services which include intrauterine insemination, in vitro fertilization treatments and medications. Participants have access to a proven physician network, financing options and free consultations.

For more details members can go to www.bcbsnc.com/blue365. If you are a BCBSNC policyholder and have not joined Blue365 it’s easy to join and offers great deals to improve your health. From the www.bcbsnc.com website click on “Go to Blue365”.

This is important to know if you’re almost 65 & on a small group health plan

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Unlike large employer group plans,  employees on small group plans (fewer than 20) are required to enroll in Medicare Part B when they turn 65. Part B helps cover the cost of doctor visits, outpatient care, some preventative services, home health care and durable medical equipment. Once you enroll in Part B you have 6 months to purchase a Medicare Supplement without going through medical underwriting (being required to answer medical questions). If you have concerns about being declined or charged a higher premium due to your health status you should purchase your own plan before the end of this six month window.

7 Tips for Finding the Best Health Insurance Deals

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As they say, “knowledge is power”. The information below will help you become a savvy health insurance shopper and find the best policy or policies for you and your family:

Explore your options with an agent who represents several health insurance companies and can help you make comparisons. There is no charge for this service and it can save you a lot of time and aggravation. Once you have educated your agent on your budget, expectations, doctors and preferred hospitals, he/she can advise you on the policies and insurance companies that would best fit your needs.  For quotes from several top insurance companies or additional information, Click Here.

Don’t wait until the last minute to apply for insurance. This is probably the best way to make sure you get the best possible deal. With the passage of the Affordable Care Act you may quality for government help paying for your health insurance policy.  Unless you have a qualifying life event (i.e. losing your health insurance due a job loss, moving to a new area, divorce or birth of a child) that gives you a 60 day period to purchase health insurance, you can only enroll in ACA compliant health insurance  during Open Enrollment (from November 1st until December 15th). If you apply during Open Enrollment your policy is effective January 1st.

Understand the following 4 insurance terms and use them to evaluate your choices:
Deductible – Dollar amount of medical expenses you pay before your insurance covers you.

Coinsurance – After the deductible this is the percentage the insurance company must pay.  For example, if your plan is an 80/20 this means the insurance company must pay 80% and you must pay 20%.  It is important to purchase a plan that has a limit on the dollar amount you are required to pay.

Co-payments – Fixed dollar amount you pay for a doctor visit, emergency room visit or a prescription drug.

Maximum out of pocket – This includes every dollar you pay for prescription drug, co-pays and deductibles using your insurance card. Once you reach your maximum your insurance company must cover all your medical expenses the rest of the year. The maximum out of pocket resets itself every January 1st.

Make sure you understand how your policy covers prescription drugs.  This means you must understand the deductibles, co-pays and yearly maximums.

If you have children who are 18 or younger and your income for the past year is low, your children may qualify for reduced or free government sponsored health insurance. For additional information contact the NC Division of Medical Assistance at 800-367-2229 or www.nchealthystart.org.

North Carolina State law requires university students to have health insurance. If your children are college students contact their Student Health Services and request information on their student health insurance plans.  Compare the cost of their university plans to your cost of adding them to your policy.

Consider purchasing an IRS-Qualified High Deductible Health Plan (HDHP).

Purchasing one of these policies can reduce your monthly premium by 50% or more.  This is a perfect solution for healthy people who rarely go to the doctor.  These HDHP’s can be paired with a Health Savings Account (HSA) that offers additional savings by reducing your taxable income. Unlike the traditional health insurance plans, the policy holder pays for all medical expenses until he reaches his deductible. Like traditional plans, HDHP’s have a wide range of deductibles, coinsurance options and benefits.  .

 

Avoiding COBRA Confusion

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COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) allows workers and their dependents to purchase group coverage for 18 months (or sometimes longer) when the worker is voluntarily or involuntarily terminated. Workers who elect this coverage can pay up to 102% of the premium that the employer pays for coverage. The employer has 44 days to notify the terminated employee of his or her COBRA rights and the employee has 60 days to respond. To avoid COBRA confusion individuals should be aware of the following key points:

  1. Although the former employee has 45 days to make the initial payment, they must pay back to the date the coverage ended. Therefore, if their coverage ends on February 28th, they receive their COBRA letter on March 5 and elect the COBRA on April 30th; they must pay for March, April and May.
  2. Even though the former employee does not have health insurance during the COBRA election period he can purchase COBRA for all or one family member if there is a medical emergency.
  3. A former worker can accept COBRA for a family member with health problems even if he does not accept it for himself.
  4. Normally the former employee can purchase dental COBRA for 18 months even if they decline the Medical.
  5. Former workers are not required to stay on COBRA for 18 months.
  6. Instead of accepting COBRA you may be eligible for a Marketplace Plan with a government subsidy to help you pay for your health insurance.
  7. Finally, since COBRA is not recognized as credible coverage by Medicare, it is unlikely that this is your best option if you or your spouse are Medicare eligible unless you expect to get a job with health benefits very soon.

Help for High COBRA Payments

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If you’re one of those folks who accepted the COBRA offer from your employer thinking you would quickly get another job that never materialized there is a new Special Election Period (SEP) to help you. Perhaps you were offered a going away package that included your former employer paying all or most of your COBRA medical plan for several months. If the payment ended before you got another job it is unlikely that COBRA is affordable to you as an unemployed person. Since your former employer is no longer helping you pay for your health insurance you might need help from another source. To eliminate this burden CMS(Centers of Medicaid and Medicare) recently announced that you have until July 1, 2014 to apply for a health insurance plan through the Marketplace with a government subsidy.