Eligibility for medicare question

Aug 22, 2007

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  1. Winter_123
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    Winter_123 Guru

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    Newbie to medicare supplement question:

    Do you have to be collecting social security to qualify for medicare when you tun 65? What if you are still working and not collecting social security but just want medicare? Can do or no can do?

    Thanks.

    Winter
     
  2. midwestbroker
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    When you turn 65 you get Part A regardless of SS. You can elect to Part B if you choose, but if you have creditable coverage you can elect not to have Part B until your coverage stops.
     
  3. Frank Stastny
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    I would add this to your comment Mike.

    If one is still working at age 65 and has group insurance/credible coverage, Part B should NOT be taken at that time unless they are ready to also take a Med Supp policy.

    As soon as Part B is taken the "Open Enrollment Period" starts and only lasts for six months.

    I have had individuals take Part B at age 65, keep their employers group policy instead of taking a Med Supp policy and then two years later decide to retire. In the mean time they have contracted major health problems.

    Then, when they finally decide to take a Med Supp they find out that their Open Enrollment period has expired and now they cannot answer health questions on the Med Supp application.

    I don't remember seeing an employers group health plan that has better benefits than a Med Supp policy. Even if the premium is paid in full by the employer, very doubtful today, there are still going to be substantial deductibles and co-pays.
     
  4. senior-advisor-indiana
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    Frank, they should still be in a special open enrollment period after they drop their group coverage.
     
  5. Frank Stastny
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    I don't know what you mean by a "special open enrollment period", however, I do know that as soon as an individual takes Part B they have the first six months after the Part B effective date to take a Med Supp policy without having to answer health questions on an application.

    There is no "special open enrollment period" for people who are still working and also have Part B if they decide to take a Med Supp after the "Open Enrollment Period".

    Once that initial six months has expired, regardless of what kind of group coverage they may have, their Open Enrollment period ends if they want to take a Medicare Supplement policy.
     
  6. Winter_123
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    I thought that once a year every carrier had to have a one month open enrollment for Plan A regardless of how long it had been since they enrolled for Part B. I don't know. I am asking.

    Winter
     
  7. Frank Stastny
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    There is only one Open Enrollment and that is the first six months after the effective date of Part B. Once that has expired then the individual will be required to answer health questions on the app from that point forward.

    Missouri and California are the only two states that I am aware of that have a Guaranteed Issue provision. But, is not an Open Enrollment period.

    There are no rules and regs that I have ever heard of that requires insurance companies or even lets them have an additional Open Enrollment period for any of the Medicare Supplement Plans.
     
  8. senior-advisor-indiana
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    There is only one "open enrollment" period. But if one loses their group coverage then the have like 63 days to get a med supp GI. It asks that question right on the application for med supps.
     
  9. Winter_123
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    I can see where a regular guy like me could get confused. I did a google search and apparently live in the only state that has this requirement:

    During a guaranteed issue period of at least one month each calendar year, as established by the issuer, every issuer shall offer standardized Medicare Supplement Plan A, as defined by rule, to all applicants on a basis that does not deny coverage to any individual or group based on health status, claims experience, receipt of health care, or medical condition. [FONT=courier, fixed][1991, c. 740, §13 (new).][/FONT]

    Winter
     
  10. Frank Stastny
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    Can you quote the exact part of that question or from the Medicare Guide book that states, if the person answers yes to that question, that a Medicare Supplement policy will be issued as Guaranteed Issue?

    Like you, I have apps from several different companies and they all ask that question about 63 days. None of my apps say anything about a Med Supp policy being guaranteed issue. I will wager you any amount of money that it isn't there and that there is only One Open Enrollment Period and no Guar Issue going from a company group plan to a Med Supp.

    The question about, "any other health insurance within the past 63 days" is to determine if the company will impose a waiting period for pre-existing conditions. If they answer no to that question some companies impose a 60 to 90 day waiting period for pre-existing conditions. If they answer yes to that question then all conditions are covered as of the effective date of the policy.

    An individual can have Guar Issue in some cases if they have a MA plan, but never if they have an employers group plan. Unless there are individual state laws that supercede Medicare's rules and regs like in Missouri and California.

    Wanna go "all in" with me on that one? :D
     
    Last edited: Aug 22, 2007
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