What Happens in This Situation (Small Group)

[wehotex]

when the owner of the Company qualifies for Medicare (he has no dependents on the group policy), can he cancel himself from the group and use his Medicare benefit instead? How will his premium and benefits of the employees be affected? Can he even do this?

 

[leevena]

You can always opt out of the group plan, but you need to check witht he carrier (assuming small group) for pariticipation requirements and how it would affect the rates.

 

[DS4]

Medicare is a valid waiver.
Owner can waive off the group and purchase a med supp & PDP.

 

[ABC]

Should not be a problem

Should he have to stay on the group plan send in his medicare card to the carrier and they will assign medicare rates to him.

If the group is under 20 medicare is primary.

 

[leevena]

Medicare is a valid waiver.
Owner can waive off the group and purchase a med supp & PDP.

May be a valid waiver, but if the group is two lives and owner opts out it then becomes a problem.

 

[djs]

May be a valid waiver, but if the group is two lives and owner opts out it then becomes a problem.

I have a feeling this varies by state. In California, this would not be a problem, you can do a group of 1, as long as it is really a group of 2 with a valid waiver.

Dan

 

[DS4]

I have a feeling this varies by state. In California, this would not be a problem, you can do a group of 1, as long as it is really a group of 2 with a valid waiver.

Dan

100% correct for California.

 

[Slade]

The owner should also consider if he even wants to opt out of his group plan. If he is a high income earner his Medicare Part B and Part D will be means tested. High income earners could pay as much as $369.10 instead of $115.40 for Part B. They could also have another $69.10 tacked on thier Part D drug premium.

 

[Full Throttle]

The owner should also consider if he even wants to opt out of his group plan. If he is a high income earner his Medicare Part B and Part D will be means tested. High income earners could pay as much as $369.10 instead of $115.40 for Part B. They could also have another $69.10 tacked on thier Part D drug premium.

I'm not much of a Medicare producer, but I didn't know that was the case. I've heard of higher Medicare rates if someone doesn't opt in to Part B or Part D when eligible (without other credible coverage), but not for income reasons. Can someone else verify that's the case?

 

[VolAgent]

I'm not much of a Medicare producer, but I didn't know that was the case. I've heard of higher Medicare rates if someone doesn't opt in to Part B or Part D when eligible (without other credible coverage), but not for income reasons. Can someone else verify that's the case?

It can be.

Medicare Premiums: Rules For Higher-Income Beneficiaries