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I have a lady turning 66 in May of this year, she has a group HSA. She is going to be able to keep her group after age 66, should she apply for medicare part A and B?
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maleman2045
Expert
- 87
DanDan,
G.Gordon is right: there is not "silver bullet" answer to this scenario.
But the real question is: Should your client keep her Group HSA ?
Most people do not take the time to fully explain the potential costs of Medicare Beneficiaries maintaining employer group coverage compared to the potential costs of Medicare + Med Supp or Medicare Advantage plans.
The majority of cases I've seen have:
Spend some time researching this and explaining the concept of a "good year" (little to no cost sharing) to a "bad year" (client hits MOOP from group coverage), factor in premium differences from group and what medicare plan you wish to sell. In almost all of my cases and on an annulized basis, it has been beneficial for my clients to purchase a Med Supp if they have reached 1/2 MOOP, even if they hit the donut hole.
Hope this helps,
Mike
G.Gordon is right: there is not "silver bullet" answer to this scenario.
But the real question is: Should your client keep her Group HSA ?
Most people do not take the time to fully explain the potential costs of Medicare Beneficiaries maintaining employer group coverage compared to the potential costs of Medicare + Med Supp or Medicare Advantage plans.
The majority of cases I've seen have:
- Group plan's provide much better (less "up front cost") for prescription drugs, but you need to understand what cost-sharing your client will experience with the group plan for medical coverage.
- Group Plan's monthly premium is much more than a Med Supp and/or MA Plan.
Spend some time researching this and explaining the concept of a "good year" (little to no cost sharing) to a "bad year" (client hits MOOP from group coverage), factor in premium differences from group and what medicare plan you wish to sell. In almost all of my cases and on an annulized basis, it has been beneficial for my clients to purchase a Med Supp if they have reached 1/2 MOOP, even if they hit the donut hole.
Hope this helps,
Mike
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- Thread starter
- #4
- 598
Yes, Thank you!
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I have experienced this as well.
One point I haven't seen mentioned is if the employer has more than 20 employees. If this is the case then Medicare becomes secondary coverage. Whenever this happens, it is not uncommon that Medicare will not pay any of amount not paid by the group or if they do it is a very small portion of the unpaid charges. Medicare will very seldom pay the total amount not paid by their group insurance.
As far as A is concerned, this is a no cost option, and I would think it appropriate to enroll, since she is entitled to it and all companies expect everyone over 65 to be on Medicare.
As to B... she can opt out of coverage as long as she remains employed and covered by group insurance. Loss of either means she will have to enroll in B or expose herself to the Late enrollment penalty (10% per year).
If her group insurance is in a HSA, I don't think she can contribute since she is over 65, so this will mean the end of group coverage unless there is an alternative choice. If not, then she will be expected to enroll in Medicare B as I said.
I am over 65, enrolled in Medicare A and B, enrolled in a Medicare Advantage plan, and have retiree group insurance. With the high cost of MA MOOP, my retiree group (supplemental) insurance picks up after a small deductible, and acts as a tie-in plan to my MAPD. The benefits package must be designed and approved for something like this.
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DanDan Love the avatar
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I think if you dig a little deeper, you will find this person probably has Medicare Part A, as it is premium free, and, not Part B.
As she currently has employer coverage, and, she is over 65, her employer plan is primary. Therefore, no reason to trigger Part B.
I have one question.
Is she currently an active employee, and, at age 66 she will become a retiree??
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