1. Retirement Health Care
Part 2: Medicare Strategy

2. Refresher of Medicare program
A Hospital insurance
B Medical insurance
C Medicare Advantage
D Prescription drug

3. Medicare Options

4. Medicare Decisions Option 1 Option 2 Original Medicare
Sign up Original Medicare
Part A, B
Decide if you need to Sign up Part D
Decide if you need to sign up MediGap policy
Option 1
Original Medicare
3 policies
Sign up Medicare Advantage
Most Medicare Advantage plans include Part D
No Need for MediGap Policy
Option 2
Medicare Advantage
1 policy

5. How to choose Medicare options
Healthy;
Less predictable cost;
NO out of pocket limit
Low premium
Original Medicare
I’m a traveler/snowbird; need the flexibility to see doctors in different areas
See Doctors often
More predictable cost
Low/no copay/coinsurance;
out of pocket limit
Higher premium
Original Medicare + MediGap
I stay at home most of time. I see doctors within my network in my residential area, except emergencies.
Healthy;
More predictable cost;
out of pocket limit.
Lower premium.
Medicare Advantage

6. Example of Medicare Plan and sample cost
Parts
Original Medicare
Original Medicare + MediGap
Medicare Advantage
Monthly Premium
Part A $0
Part B
$134
Part C -
$0- $100
Part D
$40
Included in Part C
MediGap (Plan F)
$200 - $400
Subtotal
$174
$374- $574
$134 - $234
Deductible,
Coins, Copays
Yes
Low/No
Out of pocket limit
No limit
Flexibility
Anywhere
In network; residence area
# of Policies 2 3 1

7. When to Enroll in Medicare

8. I’m turning 65 and…. I don’t have any employer group plan
I have a employer group plan (spouse/ myself still working)
AND the employer plan covers 20 or more employees
I have a employer group plan (spouse/myself still working)
AND the employer plan covers less than 20 employees

9. Turning 65: I don’t have any employer group plan
Social Security Status
Part A and B
Part D
Part C/ MediGap
(if needed)
When to Enroll
I’m receiving Social Security
Auto enroll at 65. No action needed
Need to enroll
Initial Enrollment Period.
Starts 3 months before 65th birthday; Lasts 7 months
I have not received Social Security
If you have coverage from Retirees health plan or COBRA, you are in these categories.
You still need to enroll in Medicare at 65 even with retirees health plan or COBRA.
These plans will be secondary to Medicare.

10. Turning 65: I have an Employer Group Plan (>20 employees)
Social Security Status
Part A and B
Part D
Part C/ MediGap
(if needed)
When to Enroll
I’m receiving Social Security
Auto enroll at 65.
Check with employer for declining Part B enrollment
Check with employer for delayed enrollment
Special Enrollment Period.
(Part A/B: Starts at age 65 and extends until 8 months after coverage ends)
within 63 days of coverage end
I have not received Social Security
Talk to employer to see if they require you to sign up for Medicare.
Employer’s drug plan must be a creditable drug plan which offers at least as comprehensive coverage as Medicare.

11. Turning 65: I have a Employer Group Plan (<20 employees)
Social Security Status
Part A and B
Part D
Part C/ MediGap
(if needed)
When to Enroll
I’m receiving Social Security
Auto enroll at 65. No action needed
Check with employer for delayed enrollment
Need to enroll
Initial Enrollment Period.
Starts 3 months before 65th birthday; Lasts 7 months
I have not received Social Security
You need to sign up for Part A and B.
You may consider keeping your group plan as supplemental insurance.
Talk to your employer to see if they require you to sign up for Part D. If employer’s drug plan is creditable, it might be best to delay Part D enrollment.

12. To-do list for Advisors regarding Medicare Enrollment
Client is getting close to age 65
Review options: Original Medicare vs.. Medicare Advantage
No group coverage;
Sign up for Medicare A, B, D 3 months prior to 65th birthday
Client is 3 months before turning 65
Has group plan covers 20 or more employees
Talk to benefits administrator 3 months prior to 65th birthday. Delaying Medicare enrollment might be better.
Has group plan covers < 20 employees
Sign up for Medicare Part A, B 3 months prior to 65th birthday
Talk to benefits administrator 3 months prior to 65th birthday. Delaying Part D might be better.
Client is over 65 and lost group coverage
Sign up for Medicare Part B within 8 months of coverage ending; Sign up for Part D within 61 days of coverage ending.

13. Review of Enrollment Period
Enrollment Type
Enrollment Period and Coverage start
Initial Enrollment Period
(for client turning 65)
Starts 3 months before 65th birthday and lasts 7 months
Coverage starts 1st of month client turns 65 (or 1st of month after enrollment if later)
Special Enrollment Period
(for client covered by Employer Group Plan >20 employee)
Starts at age 65 and extends until 8 months after coverage ends
Coverage starts 1st of month of enrollment (if enrolled no later than month after coverage ends) or 1st of month following enrollment if later
General Enrollment Period
(Anyone who missed enrollment)
Runs Jan. 1 – March 31
Coverage starts July 1

14. Important things to keep in mind
I’m turning 65
Medicare enrollment is NOT automatic
I have group retiree benefit or COBRA
You still need Medicare
I missed my enrollment period
You have a LIFETIME penalty of higher premiums
You are likely to have months of coverage gap
I enrolled in Medicare
You can not contribute to HSA
I enrolled in Medicare Advantage
You don’t need a MediGap policy
I use HSA to pay Medicare cost
HSA can be used to pay Medicare premium, copay, co insurance; HSA can NOT be used for MediGap premium

15. Where to Enroll in Medicare
Website
Part A and Part B
Go to
Part C and Part D
Go to
MediGap

16. Take Aways Medicare enrollment needs careful planning
Mistakes can cost clients thousands of dollars in penalties
It is important to enroll on time
Need to understand how other polices work with Medicare