T65, IRMAA, COBRA, and more fun things.

[sshafran]

While you all sit back, relax, count future commissions from your fantastic AEP - may I bother you for just a moment?

So, here is the case I'm working on today.

Prospect has a nice income... I met with him in his (beautiful) home back in April 2018. He is a T65 August 2018. At the time, still working, covered under group. His wife is also covered under his employer group plan.

Enrolled in Part A only right now (8/1/18).

Fast forward to today. He plans to retire end of year. Wants coverage 1/1/19.

Medicare w/ IRMAA: Either $352.20 or $433.40 - He wasn't exactly sure of 2017 income.
Plan G: $110
Part D w/ IRMAA: Approx $20 + either $51.40 or $70.90

In talking with him, we used the lower numbers to project total cost - approx $533. If his income is higher than he thinks - it's $634.

(I'll give you all a moment to curse the communism of this system, which dis-incentivizes income. Go ahead - it's ok. Alright, now let's get back to the case).

--

Here is the dilemma. He said that he can get COBRA for 18 months - and he thinks it'll be less expensive. He is waiting on them to get back to him, but the HR person told him somewhere in the neighborhood of $400.

Thankfully, he wants advice - wants to make sure he makes a sound decision - he's not the type of guy who said, "this is too expensive, screw you."

Initially, I thought, this may not be a bad deal for him - wait a bit, get the COBRA, keep costs down, avoid IRMAA's communistic stick for a bit - and he said his current coverage is very good.

--

So, to the forum I go - as I've not run into this situation before.

Seems like the biggest reason for him to bite the bullet and go full Medicare is this COBRA trap.

i.e., no SEP to get Medicare Part B a whatever start date he wants. It would need to all start during a July 1 date as a result of a GEP.

--

The way I see it - he either starts it now (1/1/19), or July 2019, or July 2020.

Any reason to wait for Medicare + IRMAA + Supplement?

Or any reasons (other than the loss of the SEP) to decline COBRA and go straight Medicare?

Any other things I should consider when talking to him? Will having Medicare Part A (w/o B) + COBRA affect him at all - negatively?

Thanks in advance!

 

[LostDollar]

For the presented situation, the first thing I would look into is a combination of three things:
Would he be willing to wait until Jan 4 to retire?
Would the company allow him to wait until Jan 4 to retire?
If he waited to retire until Jan 4, would the company allow him to have active employment health coverage for the entire month of January?

 

[sshafran]

For the presented situation, the first thing I would look into is a combination of three things:
Would he be willing to wait until Jan 4 to retire?
Would the company allow him to wait until Jan 4 to retire?
If he waited to retire until Jan 4, would the company allow him to have active employment health coverage for the entire month of January?

Ok, I'll admit, I'm lost on the Jan 4 significance.

 

[vic120]

Probably has copays and deductible on Cobra, Possibly networks restrictions, besides having to deal with when to sign up for part B, Difference in premium is not great considering his income. Plus he would have to wait the full 18 months to avoid late enrollment and penalty.

Personally, I don't see the point in waiting, but some are stuck on getting the best cost by a penny

 

[hockeyday]

I would find it very hard to believe that cobra would be 400 per month for 2 people, if he goes on medicare you need to also look At the cost of insurance for his wife, if cobra for 2 adults is really 400 dollars its a easy decision

 

[vic120]

I would find it very hard to believe that cobra would be 400 per month for 2 people, if he goes on medicare you need to also look At the cost of insurance for his wife, if cobra for 2 adults is really 400 dollars its a easy decision

I missed that No way for 2 people

 

[sshafran]

The 400+ was his portion only, not factoring his wife.

 

[sshafran]

Plus he would have to wait the full 18 months to avoid late enrollment and penalty.

Ok, I'm a little slow on this. Why full 18 to avoid LEP?

 

[vic120]

Ok, I'm a little slow on this. Why full 18 to avoid LEP?

I could be wrong I can't find it now, I could swear I saw on medicare.gov in the past that if you have cobra you could only get part B without penalty after the full 18 months.

I remembered because I thought it strange but I don't see it now. Or possibly I have it confused with GI rights?

 

[hockeyday]

400 for one person for bad coverage is low, I think the numbers will lead you to a final decision, I had one recently that the company was going to pay the full cobra for husband and wife for 18 months,