You shouldn’t pay a penny more than you need to when you enroll in Medicare coverage.
Here are some common blunders by folks on Medicare.
1-You are still working when you turn 65 and become eligible for Medicare. You automatically sign up for Part A by calling Social Security. Part B is optional and depends on how many people work at your company.
If you work for a firm with 20 or fewer workers and you have health insurance, you should sign up for Part B, which covers doctor bills. The fee for Part B is $109 a month, if you make $85,000 a year or less ($170,000 for a married couple). Medicare will be your primary insurance provider, and your coverage from work will be secondary.
If you work for a company that gives you health insurance and has more than 20 workers, its coverage continues and you don’t need to enroll in Part B.
But you MUST ENROLL when your status at the company changes. You have to enroll in Part B within eight months, or you face a penalty, a higher Part B premium for the rest of your life.
What are the status changes that trigger the possible penalty?
- If you retire, you must enroll in Part B, whether or not the company has retiree coverage.
- If you get laid off, and file for COBRA, a way to continue your health insurance, you still have to enroll in Medicare Part B.
- If you had coverage at the company through your spouse, and your spouse gets laid off, you can continue health coverage through COBRA, but you MUST file for Medicare Part B. Same rule if you got divorced and are keeping coverage through COBRA, you still need to enroll in Part B.
2-You are a cancer patient and are taking some costly drugs. Drugs you can take at home- a pill, a liquid, a compound you self-inject-all are covered by Medicare Part D, a policy to help pay for prescription drugs. There are co-pays and deductibles, and when you reach a certain level of out-of-pocket payments, the policy will pay for 95% of the cost of your medications,and you pay only 5%.
But you have a much greater financial exposure for drugs you receive in a doctor’s office or a hospital out-patient setting. Drugs administered by the physician, perhaps in an IV form, are covered under Medicare Part B, and this has a 20% co-payment. If a drug costs $5,000 a month, you will be responsible for a $1,000 payment. Many patients aren’t aware of their possible financial exposure. ASK your doctor if he can write a prescription for you to get this drug in pill form, or any other way you can take it at home where it will be covered by Part D rules.
Protect yourself if you have a major condition requiring in-office medication, by purchasing a Medi-gap supplemental policy. PlaF covers the 20% co-payments under Part B, which means it will pay for the potentially huge expenses for those drugs you take at the doctor’s office.
3-If you are in traditional Medicare, where you pay for Part B and you can use any doctor or hospitals, You SHOULD buy a Part D prescription plan EVEN IF YOU DON”T TAKE ANY MEDICATIONS. You can get a basic policy for about $30 a month. Here’s why you should do this. Open enrollment for Part D runs from October 15 to December 7. Then you are assured of coverage for the next year. If you do this and never use a pill, it will cost you $360 for the year.
It gives you protection against the unexpected. Suppose you have heart attack in January and go on a regimen of expensive blood thinners. Or some other health problem crops up, calling for lots of costly prescriptions. Without a Part D policy, you will have to pay for all those medications out of pocket. And that is likely to cost you a lot more than $360 for the year.
