Medicare Initial Enrollment - Newby Question

[Franz Kafka]

I have a new client who missed his 7 month IEP - it's been over 4 months since his 65th birthday. He's still working and covered under the employer plan but expects to retire within a year or two. Should he call and enroll in A now and opt out of B or should he wait till he retires then enroll in both A and B then? What advantage does he have by enrolling in A now?

 

[Frank Stastny]

I have a new client who missed his 7 month IEP - it's been over 4 months since his 65th birthday. He's still working and covered under the employer plan but expects to retire within a year or two. Should he call and enroll in A now and opt out of B or should he wait till he retires then enroll in both A and B then? What advantage does he have by enrolling in A now?

I guess I'm confused about the part of your question that refers to the IEP.

Everyone is enrolled automatically in Medicare Part A upon turning 65. Medicare also enrolls them "automatically" in Medicare Part B. Unless, he has chosen not to begin collecting Social Security. If he is not going to begin collecting SS then he must go to his SS office and enroll in Medicare.

First find out if he has received his Medicare card and ask specifically if it shows both Medicare Part A and B. If it does I don't think that at this time he can opt out of Medicare Part B, he will have to ask.

You may want to talk to him about dropping his company insurance and taking a Med Supp or an MA policy now. I have very rarely seen a company plan that has better benefits than a Med Supp. There aren't very many companies paying the premium for the employee's health insurance either.

 

[The Rabbi]

Part A is automatic at 65 as well as B which he would opt out on if covered by employer. His employer would want him on Medicare for Part A. It would reduce his premium. He should call Medicare and check his status. If he is getting a good deal on his group then there isn't any sense to getting Part B until he retires. Maybe his employer will bonus him to get off the group plan and use Medicare. Then you can sell him a sup or enroll in a MAPD.

 

[Franz Kafka]

Still trying to learn here. If enrollment is automatic, why is there IEP?? He has no card so I'm assuming he's not collecting SS yet. Will call and find out tomorrow. Thanks!

 

[Frank Stastny]

Still trying to learn here. If enrollment is automatic, why is there IEP?? He has no card so I'm assuming he's not collecting SS yet. Will call and find out tomorrow. Thanks!

I believe that in order for one to effectively help a prospect make an intelligent, well informed decision regarding their health care an agent needs to know all aspects of the senior market.

The IEP is only applicable to Medicare Part C plans. It has nothing to do with Medicare Supplement Policies. They are as different as night and day.

When a person turns 65 they are automatically eligible to begin receiving Medicare. If they are going to draw Social Security payments Medicare will usually send the individual their Medicare Card about two to three months in advance of the month of their 65th birthday. In general their Medicare benefits will begin on the first day of the month in which they turn 65. The effective date on their Medicare card will be the first day of the month they turn 65.

If they are taking part B of Medicare they have six months from the effective date to take a Med Supp policy without having to answer any health questions. This six month period is called "Open Enrollment". They cannot be denied a Med Supp policy during that time. They also do not have to answer any health questions on the application. You can even enroll people who are in the hospital during "Open Enrollment".

Tell you what, I could type all day explaining this. When you read this give me a call and I will give you a crash course in Medicare and Medicare Supplement policies.

You may be doing your prospect a disservice by only presenting the Medicare Part C plans to them. There are still a lot of people who prefer the coverage offered by a Med Supp plan.

I believe that it is extremely important that you also learn Medicare Supplements now. Assuming your prospect would rather have a Med Supp you can do that regardless of his health while he is still in the Open Enrollment period.

My number is below . The earlier you call today the better.

 

[Russ]

Medicare supplements are not that hard to understand...as a matter of fact their rather easy to learn.

As far as open enrollment period and no health questions asked...that is true, but there are options for someone if they have health issues and their beyond the 6 month OE period....AARP is a great option....only the kidney dialysis question and competitive rates.

 

[Frank Stastny]

Medicare supplements are not that hard to understand...as a matter of fact their rather easy to learn.

I agree. I can teach a new agent everything they need to know about Medicare and Medicare Supplement policies in a few hours. Teaching them to sell it takes longer.

As far as open enrollment period and no health questions asked...that is true, but there are options for someone if they have health issues and their beyond the 6 month OE period....AARP is a great option....only the kidney dialysis question and competitive rates.

AARP may be a "great option" in your area but I would not consider them to be competitive in the areas where I market Medicare Supplement policies. I would only recommend AARP as a last resort.

In this case though, wouldn't it better to present the option of a Medicare Supplement policy while his prospect is still in the Open Enrollment period? He said he was going to call his prospect and I am trying to help him help that prospect today.

 

[Russ]

I agree. I can teach a new agent everything they need to know about Medicare and Medicare Supplement policies in a few hours. Teaching them to sell it takes longer.



AARP may be a "great option" in your area but I would not consider them to be competitive in the areas where I market Medicare Supplement policies. I would only recommend AARP as a last resort.

In this case though, wouldn't it better to present the option of a Medicare Supplement policy while his prospect is still in the Open Enrollment period? He said he was going to call his prospect and I am trying to help him help that prospect today.

Where I work, AARP's rates are as competitive as anyone's. Mutual of Omaha just came back in this area and their very close to AARP.

Continental Life is an option, but I read somewhere else in this forum that they were going up 25%(are they?).

Shenandoah Life is too high.

Yeah...a med-supp now for his client is an option, but if the "prospect" has group coverage at a better rate is the question.

 

[Frank Stastny]

Where I work, AARP's rates are as competitive as anyone's. Mutual of Omaha just came back in this area and their very close to AARP.

Continental Life is an option, but I read somewhere else in this forum that they were going up 25%(are they?).

In Missouri Mutual of Omaha, United of Omaha now, is only competitive if the agent enrolls both a husband and wife at the same time. Enrolling an individual in United of Omaha would be totally out of the question. Their rates for individuals are way "over the top". Husband and wife enrolling at the same time get a 12% discount. That is the only thing that makes them competitive, in Missouri.

AARP may be competitive "where you work" but that doesn't mean that they are in other states. This is why, when an agent asks for help, more accurate information can be given if the agent identifies the state he/she is working in.

Each company will have different rates and increases in almost every state that they do business in. I stated earlier in another thread that Continental Life in Missouri was going up 25%. That does not mean that Continental Life is going up 25% in all other states or that Continental Life is even having premium increases in other states. Premiums and premium increases are state specific.

Shenandoah Life is too high.

Yeah...a med-supp now for his client is an option, but if the "prospect" has group coverage at a better rate is the question.

That is partially correct. However, the rate one pays is not the only consideration.

If the prospect already has Part B of Medicare, is not in the best of health and his company does not offer a continuation of group coverage after retirement, like GM use to, it may be in his best interest to look at Med Supp policies while still in the Open Enrollment period.

Let's assume that the prospect's company does have a "better rate" or premium that he is paying today. Group plans change almost every year. Many times deductibles go up along with co-pays. Many limit the individual to specific doctors and hospitals. (HMO's). Not everyone wants an HMO if they know that other options are available.

I have yet to see a company group plan that provided the flexibility and the level of coverage that a Med Supp has especially for the premium. I can put a 65 year old in a Med Supp policy for under $100 per month. The only additional charge to the client will be the Medicare Part B Deductible.

 

[retread]

Still trying to learn here. If enrollment is automatic, why is there IEP?? He has no card so I'm assuming he's not collecting SS yet. Will call and find out tomorrow. Thanks!

If, indeed, he has no card (not just lost or forgotten), then I would assume he is not enrolled in Medicare. Social Security actually does the enrolling... so if he is not on SS retirement, he may very well not have been enrolled.

If this is the case, make sure you tell him that if he is still working and on group insurance, he can delay enrolling in Part B. This will save him $96.40 per month. I run into seniors all the time that continue to work and have insurance but pay that stinkin' $96.40 to SS when they don't have to.

They have to have Part B (as well as Part A) to get either a Med Sup or a MA plan, however. If their group coverage is affordable, they may be better off with it rather than either a Med Sup or MA. Once they drop their group, they will more than likely never get it back. Don't forget to consider the Part B premium when you look at the cost of Medicare plans against group ins. premium!