Some forms or information for your assistance:I had no idea Medicare was so complicated.
Now I'm really anxious about us incurring penalties or fines for not signing up in time (it's almost 6 months since she turned 65).
You had up by 3 months after she turned 65 to sign up without any penalties incurring. You are now past the timeframe. Your goal is to minimize this amount now.
Our current plan is indeed through a business I own, with only myself and my partner (so, our families are the only participants).
I don't know if that means we have "a personal family plan" and I don't understand if these penalties are only assessed if and when she goes on Medicare, and if the penalty increases the longer she waits, etc.
They increase the longer she waits.
https://www.medicare.gov/basics/costs/m ... -penalties
Our current plan is pretty good, as far as health insurance in this country goes, and if the she can stay on the current plan AND the premium differences (which so far appear to be indecipherable or unknowable given the complexities and choices) are not great, I'd certainly keep the insurance we have in place.
Medicare is only concerned about one aspect of your wife's current insurance plan. That is, if her insurance plan is "Medicare creditable". "Medicare creditable" means the employees' insurance policy that includes drug coverage is as good as what Medicare provides. This is the crucial point. If it is, then she can continue on it without paying any penalties for Part B & D when she does apply for Part B in the future. If it is not, then if she continues on it, when she does apply for Medicare Part B, then she will incur Part B & Part D penalties that will last as long she is on Medicare Part B & D.
Hopefully, Oxford Health can tell you this information. Companies with less than 20 employee are not required to offer any coverage to employees ages 65+. Chances are slim that it is simple because small companies cannot afford coverage for age 65+ for those additional number of years of employment They know employees can get coverage through Medicare.. This plan most likely does not have this consideration built into it. But, for the premium, it just might be a diamond in the rough.
Vey important that you verify this plan is "Medicare creditable". Oxford Health may tell you over the phone it is creditable. You need to verify and triple check. You need them to put this in writing and signed by someone of importance in the company. There may be specific forms that Medicare requires and that are sent in to them. These are government documents, so don't take this lightly. If your plan is not "Medicare creditable", then those penalties have started accruing.
There are strict rules for when you can enroll in Medicare. There are different enrollment periods for different circumstances. This is what you need to figure out: Does your wife need to enroll in Part A, B & D now? What forms does she need to fill out and send with her application to Medicare? Has she even signed up for Part A yet? If your insurance is "Medicare creditable', what forms does she need to fill out and send to them so that when she applies for Part B later on, without incurring any penalties? Who needs to sign those forms? These are government documents, so don't take this lightly. Are you comfortable in signing them as company representative based on verbal from OXford Health? Ei: Form CMS-L564.
If not "Medicare creditable", then when is she eligible to enroll in Medicare Part B and Part D? How will the penalty be calculated? Important that you call Social Security at 1-800-772-1213. Calling between 8-10 am and 4-7 pm Wednesday through Friday are suppose to be slower times.
My thinking is that when the last of the kids turn 26 (in 8 years), we would reevaluate this. This thinking would change if (1) health care miraculously gets inexpensive and great for young people, (2) the kids get good coverage elsewhere such as their work, or (3) the difference in cost between having a private plan and medicare becomes great.
No. Medicare is dramatically different from the insurance you are used to. You already heard of IRMAAs, penalties for Part B & D. Part A B & D are independent of each other with their own deductibles, premiums, co-pays and co-insurance costs. You pay a premium for each part. Both the government and private insurance companies provide coverage. It not just one insurance plan. It is 3 plans by different companies.
You can also purchase a supplemental plan (Medigap) which will help pay most of your out-of-pockets costs for part A & B. In terms you will understand, this plan would reimburse you for all the money you paid to providers from the time you met your deductible up to your out-of-pocket max. Plus any copays not applied to your limits. It even pays your Part A deductibles. Note, again only for Part A & B costs. Does not include prescriptions drug costs. Plan G will pay for every Medicare approved cost except for the Part B deductible, currently $240. Plan N does the same except does not cover the Part B deductible, excess charges and part of foreign emergency travel costs. Strongly recommend you purchase.
https://www.medicare.gov/health-drug-pl ... n-benefits
In the meantime, I will wait for the broker to respond. Neither of us have the energy needed to become educated and informed about Medicare.
BTW, the plan we now have is the Oxford Health, EPO Non-gated, Freedom Network.
https://www.cms.gov/Medicare/CMS-Forms/ ... com/forms/
Statistics: Posted by Duzz78 — Fri Jul 05, 2024 1:45 am — Replies 38 — Views 2253