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Core Insurance Advisors

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Articles

What Medicare Doesn’t Cover

Core Insurance Advisors |

Once you turn 65, Medicare is a great way to get insurance coverage for many of your healthcare needs. Unfortunately, Original Medicare, or Medicare Part A and Part B, does […]

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The Difference between Medicare Advantage and Medigap (Medicare Supplement)

Core Insurance Advisors |

As you research Medicare Parts A & B you’ll notice that Original Medicare doesn’t always offer perfect coverage. Medicare doesn’t cover everything, and many people buy supplemental insurance to fill […]

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Everything Medicare Beneficiaries Need to Know About SEPs

Core Insurance Advisors |

Typically you can only make changes to your Medicare plan during the Annual Enrollment Period (AEP) each year. Under certain circumstances, though, you are able to make changes to your […]

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Medicare 101

Core Insurance Advisors |

Navigating Medicare can be confusing and difficult, especially if you’re receiving an onslaught of information. With an excess of information that may or may not be relevant to your situation, […]

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Tips for Seniors Staying Active and Healthy in Winter

Core Insurance Advisors |

The winter months are always tougher on people than other times of the year. It’s cold and dark all the time, which makes us want to stay in all the […]

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What is Medicare Advantage Open Enrollment?

Core Insurance Advisors |

Medicare Advantage Plans can be confusing and with annual benefit changes, your current plan may not be what’s best for you. Maybe you’re in a plan by accident that doesn’t […]

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Enrollment penalties for Medicare can affect your healthcare costs for years to come – and some do so for the lifetime of your enrollment. Whether you forgot to enroll during the Initial Enrollment Period or end up lacking credible coverage from your employer when working past 65, you could face penalties for Medicare Part A, Part B, and Part D.

If you’re late enrolling and do not qualify for a special enrollment period, the costs could add up to thousands over the years. To help you avoid this costly mistake, we’ve compiled answers to all-too-unfortunate questions regarding late enrollment penalties.

Is it possible to avoid late enrollment penalties altogether?

First things first: Planning ahead can help ensure that you don’t face the possibility of late enrollment penalties. To do so, make sure that you:

  1. Enroll during your Initial Enrollment Period (which starts three months before you turn 65)
  2. Make certain your employer coverage is credible (if still employed)
  3. Get written proof that you have credible prescription coverage
  4. Enroll in Part D within the first two months of your Special Enrollment Period (if qualified)
  5. Work with a Medicare agent to ensure that you’ve crossed your T’s and dotted those I’s

What happens if I miss a Medicare deadline? 

They say that the best-laid plans of mice and men often go awry. And the same goes for your Medicare enrollment. Sometimes life gets in the way. If you’ve missed a deadline, it’s essential to understand what types of late fees you could face. The bottom line is: You can accrue penalties for Medicare Part A, Part B, and Part D. 

Here’s how they work:

Part A – If you do not enroll in your Initial Enrollment Period, you could face a 10% penalty for 2x the number of years that you did not enroll. 

Example: You became eligible to enroll in Part A in 2017 but did not enroll until 2021. Your penalty would present itself as the extra 10% for eight years! 

Part B – If you do not sign up for Part B during your Initial Enrollment Period, you might face a 10% late enrollment penalty imposed for each 12-month period that you delayed enrollment.

Example: You did not enroll in Part B for the first two years of your Medicare coverage. You then would pay 20% more for your Part B premium. And because the premium is based on each year’s standard premium, each increase in your premium means an increase in the penalty – for life! 

Part D – If you do not enroll in Part D coverage during your Initial Enrollment Period, you can face a penalty of 1% for each month you went without Part D or other qualifying prescription coverage (rounded to the nearest $0.10). 

Do I have options?

Understanding the rules and how they can work for your situation regarding Medicare enrollment is key. The good news is that there are safeguards in place to help when your Medicare situation does not align with the set timelines. 

Consider your options for Part A, Part D, and Part C enrollments:

Part A – There are two ways to avoid Part A premiums when enrolling outside of the standard enrollment period: (1) You had qualifying coverage through your employer or your spouse’s employer, or (2) you qualify for a Special Enrollment Period (SEP).

Part B – If you have qualifying health insurance coverage (such as a large employer group health plan), you can delay part B while covered because your employer plan is primary and Medicare is secondary.

Part D – There are two circumstances in which you can avoid late fees for Part D – (1) You qualify for the Extra Help program that subsidizes the costs of Part D for low-income individuals or (2) You’ve had credible coverage through an employer or spouse. 

Worried You’ll Incur a Late Enrollment Penalty?

Don’t risk incurring late enrollment penalties for Medicare. Instead, schedule an appointment with one of our licensed Medicare advisors, who can help you make the best Medicare decision based on your situation.

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Original Medicare covers many medical needs that you might have, but it doesn’t cover everything. You might find that the copayment, coinsurance, and deductible costs take too much out of your pocket. So, if you don’t have a Medicare Advantage plan, you may benefit from a Medicare Supplement plan, also known as Medigap.

What is Medigap?

A Medigap plan is essentially a little extra cushion for your medical budgeting. It’s sold by a licensed private company and provides financial assistance to those enrolled in Original Medicare. You pay a premium to the company each month, which provides additional coverage for the enrolled individual.

How does Medigap help?

Original Medicare only pays the Medicare-approved amount to your providers. In other words, medical providers only accept up to a certain amount to be covered by your plan. Unfortunately, in many cases, this does not cover the total cost of services. That’s where Medigap comes in.  

It helps to supplement healthcare costs that linger after Original Medicare has done its part. Medicare pays its share, then Medigap pays its share. And in some cases, you’ll find that Medigap plans add benefits, such as out-of-country medical care that Original Medicare does not cover. 

Who qualifies for Medicare Supplement?

If you have Original Medicare, you qualify for Medicare Supplement insurance. However, you must have both Part A and Part B to purchase Medicare Supplement benefits.

How does Medigap differ from Medicare Advantage?

Medigap isn’t the only option for someone looking for more comprehensive healthcare insurance coverage – it’s just one of the many. Medicare Advantage plans are one of the most common alternatives to Medigap. It bundles Original Medicare (Part A and Part B) with prescription (Part D) and other healthcare benefits in a completely separate plan provided by a private insurance company. With Medicare Advantage, however, you are often bound to the networks and stipulations set forth by the private entity. 

On the other hand, Medigap works with your Original Medicare – so you’ll pay your monthly premium in tandem with the Part B premium that you pay to Medicare. You have the option to visit any doctor throughout the United States that accepts Medicare – without worrying about networks or referrals. When you add supplement insurance, be sure to note that it does not cover Part D (prescription drugs). So, you’ll want to also enroll in a Part D plan. 

How will a Medicare Supplement plan benefit me?

Your Medigap plan covers you for the rest of your life. As you age, your medical needs might change, and you want to be prepared to cover any need that goes above the coverages Original Medicare offers. The supplement insurance can help you do just that. Your Medicare Supplement plan serves as a protector for your limited income.

Get help determining if Medicare Supplement is right for you.

Not sure if Medicare Supplement insurance is right for you? Our advisors can help you determine which Medicare coverage is right for your needs. Schedule an appointment with one of our advisors today.

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If you have Medicare, you’ve probably seen the letters “AEP” floating around – especially lately. 

Medicare Annual Enrollment Period, abbreviated AEP, is the one time a year that you have the opportunity to join or make changes to your Medicare plan. 

During AEP, you can: 

  • Switch Medicare Advantage plans
  • Choose to change from a Medicare Advantage plan to Original Medicare, or vice versa
  • Add, drop, or change your Part D plan

Whatever changes you make during the AEP will take effect on January 1st of the upcoming year. For example, if you enroll in a new plan on October 20, 2021, then your coverage will start on January 1, 2022.

It’s important to evaluate your Medicare coverage each year during AEP to make sure you have the right plan for the year ahead. To help you take advantage of AEP, we’ve provided answers to some commonly asked questions. 

When is the Medicare Annual Enrollment Period?

AEP begins on October 15th and continues until December 7th each year. During this time, Medicare advisors are able to help you review your current coverage, compare available Medicare plans, and even enroll in a new plan. 

Bonus insight: Medicare advisors can begin reviewing your current coverage and comparing plans as early as October 1st. You simply cannot enroll in a plan until October 15th, but getting started early ensures you have ample time to find the right coverage.

Why is AEP important?

While you don’t necessarily need to make changes to your Medicare plan each year, nevertheless, the period gives you the chance to make sure that your plan is still meeting your needs. 

Circumstances change, and over a year, you might find that your Medicare plan has not evolved with your healthcare needs. If that’s the case, a different Medicare plan could offer other benefits and coverages that are a better fit for where you are currently.

Other factors to consider include:

  • Has your budget changed?
  • Are you taking new prescriptions?
  • Do you plan to travel more or less in the upcoming year?
  • What goals do you have for your health in the years to come?

Each year it’s important to look at things like the cost of your current Medicare and/or prescription drug plans, what’s covered under them, and which healthcare providers you have access to through your plan. If your current plan no longer meets your needs, AEP is the time to make a switch. 

How can a Medicare broker help me during AEP?

AEP is an opportunity to evaluate your healthcare needs and determine how to best plan for them in the year to come. The world of Medicare offers many options, such as getting prescription drug coverage or not, choosing a Medicare Advantage plan, or sticking with Original Medicare. 

Having a guide through the process can not only relieve stress and confusion but can also be the key to ensuring you get the right coverage. A Medicare advisor understands the ins and outs of Medicare choices and has the experience that can help you choose the plan or combination of plans for where you’re at in life. 

Here at Core Insurance, we want to make sure you have the best Medicare plan for your needs. Schedule a time to meet with one of our advisors during AEP, and we’ll help you evaluate your current plan and the plan options available to you.