Got Medicare Eligible Employees?
Let’s talk about
- What Employers Should Know About Medicare
- What Your Employees Should Know About Medicare
- Why HR & Benefit Managers may be unfamiliar with Medicare
- Medicare has different parts
- Employees may be required to enroll in Medicare when eligible
- Enrollment periods can’t be missed (without consequences)
Medicare is for
- People who are 65 or older
- People with certain disabilities or health conditions
Medicare has Four Parts
- A – Hospital
- B – Medical
- C – Medicare Advantage (AB+D)
- D – Rx
- AND ALSO: Private Market Medicare Supplement Plans
Should Employees Enroll in Medicare at Age 65?
- You have 19 or Fewer Employees? Employees MUST enroll in Medicare at age 65
- If your Employer Sponsored Health Plan isn’t considered “Medicare Creditable” then employees will be subject to a Late Enrollment penalty if they do not enroll in Medicare at age 65. (FYI: COBRA is NOT considered Medicare Creditable.)
- If enrolled in Medicare Part A, employees can no longer make deductible contributions to an HSA (in their name).
If you have 20+ employees AND offer Medicare Creditable coverage
- Employees CAN delay enrollment in Medicare Part B ($170/m) and enroll only in Part A (no cost) AND stay on your health plan
- OR: They can disenroll from your plan, enroll themselves in Medicare A & B AND enroll any family members under 65 in an ACA Plan (with income-based subsidies available, paid after tax.)
If the Employee is enrolled in an HSA compatible plan, is making contributions to the HSA and wishes to continue doing so, AND you have 20+ employees AND your plan is Medicare Creditable, THEN
- Employees CAN delay enrollment in BOTH Medicare Part A & B and keep your plan and continue making HSA contributions
- OR: They CAN delay enrollment in Medicare Part B ($170/m) and enroll only in Part A (no cost) AND keep your plan but change to a NON-HSA plan and stop making HSA contributions.
- OR: They can dis-enroll from your plan, enroll themselves in Medicare A & B AND enroll any family members under 65 in an ACA Plan (with income-based subsidies available.)
How & When do Employees Enroll?
- They should begin 4 Months Prior to Turning 65
- There are many steps, all outlined here: www.wheelersinsurance.com > Life & Health > Medicare > Turning 65? Your Medicare Enrollment Pathway
or this link: https://wheelersinsurance.com/medicareenrollmentpathway/
How can you, the employer, help?
- You can provide employees who are over 65 and enrolling in Medicare Part B with a Former Employer Verification Form – Form CMB-L564 (available to download from https://wheelersinsurance.com/medicareenrollmentpathway/#getpartblater) so they can avoid late enrollment penalties
If they are enrolled in both our plan and Medicare, how does these plans interact? The Employer Plan is the Primary Payor of Claims UNLESS:
- You have 19 or fewer Employees: Medicare is Primary payor of claims
- You have 20 – 99 Employees: Medicare is USUALLY the Secondary payor of claims
- You have 100+ Employees: Medicare is ALWAYS the Secondary payor of claims
Employees MAY find Medicare a more affordable option than paying for the employer plan.
In our group and one-on-one meetings, we cover these topics (and answer questions):
- When should I enroll in Medicare A & B? What are the consequences for missing an enrollment period?
- What are the differences in Costs & Benefits between the employer plan and Medicare?
- Should I enroll in Medicare even though I am still working?
We offer initial and ongoing support to employees
- We help employees enroll in Medicare A and/or B
- We review medication and medical coverage needs (initially and annually)
- We review and compare options for Part C, Part D & Medigap Plans (initially and annually)
- We assist with enrollment and all other interactions with the insurance company after enrollment
The Medicare Advisors at Wheelers Insurance will help each Employee make the right decision for them. We don’t charge Employers or Employees for our services.
How can you help us help your employees?
- Could you promote our services with your 63+ year old employees? We can supply flyers and business cards.
- Could you promote our monthly Medicare Seminar/Webinar with employees? These are generally held early evening and are about 45 minutes long. We can email reminders to your designated contact and/or provide flyers you can post.
- Could you host us at your site for a lunch time meeting? We can commit to coming to you with 4 or more confirmed attendees, and we only require a space where we can set up a projector and screen.
- NOTE: These are educational events, not sales meetings, and there is no obligation on the part of any attendee to work with us subsequently.