I’m not about to tell you the senior market is set to explode as 10,000 Baby Boomers turn 65 every day in this country because I’m sure you’ve already gotten word by now. Instead, I want to remind experienced agents or those just getting started in this market that it’s mostly a matter of timing for seniors when it comes to getting the most out of Medicare.
You can strengthen your business as an agent by helping your prospective clients navigate the complex Medicare enrollment schedule. If seniors enroll without knowing about possible penalties, their decision could literally cost them for the rest of their lives.
Most seniors and agents aren’t aware Medicare enrollment is sensitive to time. In fact, the program will only let you know you are eligible to enroll if you are already on Social Security. If a senior waits until full retirement age to enroll in Medicare, he or she will probably owe a late enrollment penalty for the rest of his or her life. And as the full retirement age for Social Security inches past 65, the penalty increases, too.
If a senior does not sign up for Medicare during his or her predetermined seven-month open enrollment period, he or she has to pay a 10 percent annual penalty on the Medicare Part B premium along with a one-percent monthly penalty for Medicare Part D for every month without coverage. The good news is the penalty does not apply as long as you have some sort of credible coverage to give you a special enrollment period to enroll into Medicare Part B with no penalty.
Not everything counts as credible coverage, either. Group coverage based on current employment does count, for example, but a group retiree plan does not. COBRA coverage doesn’t count either. Perhaps to add insult to injury, seniors have to wait until the general enrollment period (January 1 to March 31) to sign up for Medicare, then wait until July 1 to actually use the coverage.
I’ll give you an example of how these penalties might sneak up on seniors and agents:
I have an 83-year-old-client whose husband passed away on April 19. Her group retiree coverage ended on May 20. She told me that because her group retirement plan had great coverage, she never signed up for Part B. I was sure I heard wrong when she informed me she wasn’t eligible for a special enrollment period, but she was right.
When I called Social Security myself to find out why, I was told that a SEP is based on current employment — retiree coverage doesn’t count. My client has Medicare Part A, but won’t be able to enroll in Part B for over a year. I enrolled her into a Part D plan, and Medicare didn’t charge her a late enrollment penalty since she had credible coverage. But Medicare won’t budge on her Part B coverage. One worker even told her that she would have to pay the penalty for not signing up back in 1999, when she first turned 65!
Here is the real kicker though, the retiree group coverage was through the Federal Employees Blue Cross Blue Shield plan and they have provided no assistance whatsoever.
The best advice you can pass along to your clients is: Enroll in Medicare Parts A and B when you first turn 65. If you aren’t drawing Social Security, you can pay your part B premium on a quarterly basis. You will have to sign up within your seven-month open enrollment window. Part D has a stiffer penalty, but at least you have the same enrollment window.
As well all know, the good news with Part D is its Medicare enrollment period is October 15 to Dec 7 with coverage starting January 1.
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