<p>DH turns 65 in January (I am significantly younger - haha!). Recently he has started to receive an avalanche of information and cards inviting him to sign up for ‘Medicare’. I assume these cards are from private insurance companies, not Medicare.</p>
<p>What do we need to know and what do we need to do on the occasion of this momentous birthday? </p>
<p>Do you HAVE to sign up for Medicare at 65? Do you just discuss it with your present insurance provider or do you have to go through some sort of government Medicare office?</p>
<p>Any other areas we need to look into? He has no plans to retire at this time.</p>
<p>Check ASAP with your insurance provider and with the company your husband works for. The company my husband worked for for decades (very large oil company) automatically boots people off the company medical plan as soon as they are eligible for medicare - no option to stay on it is offered. For a while they allowed retirees to stay on their prescription plan, but a few years back they booted them off that as well meaning he had to sign up for the dreaded Medicare D plan. Check with your plan.</p>
<p>Not an expert but here is a rough outline:</p>
<p>Medicare A is the basic medicare plan and should not cost anything if you have been paying medicare taxes. It is mainly for inpatient care. But it does not cover the full cost of everything and my husband has a supplementary plan we pay for that covers what medicare does not cover. The supplementary plans are offered by private insurance companies. There are various levels of supplementary plans (A, B, C etc) - he opted for the higher level plan (F I think) as he has a lot of health issues - it has turned out to be a good choice as almost 100% of his non prescription cancer treatments have been covered. Medicare B does have a monthly cost and is for doctors visits, medical supplies etc. </p>
<p>Medicare A & B do not cover prescription costs for medicines outside of those given in hospital. For these you need medicare D. You have to sign up for Medicare D with a private provider. Providers will vary by state (our state has 40-50 I think) and each will have different fees, deductibles, and may cover different drugs. We have to recheck every year in around November to make sure we are with the best provider - medicare has an online program where you can run your drugs through the different providers to see which one is best for you. It can be a real PITA. And then there is the dreaded donut hole to contend with if you have expensive prescriptions.</p>
<p>If you don’t sign up for the paid for medicare plans when you are first eligible, there may be some penalties (higher premiums) when you eventually sign up.</p>
<p>oh - some over 60s organizations offer help in understanding medicare options. We are both pretty computer savvy and consider ourselves quite intelligent, but we did go to the help sessions at a local over 60s club to get some guidance about medicare D and how to choose the right provider and use the online comparison program. It is quite a complex system and takes some understanding, particularly the donut hole rules which defy common sense. I have spent many hours trying to anticipate what his meds will cost but never can come up with the same numbers we end up paying.</p>
<p>We are in a similar situation. My husband is over 70 and I am significantly younger. He is still working and covered by group health insurance. In this situation, my understanding is that he will not be penalized by higher premiums when he eventually signs up for Medicare.</p>
<p>You should also think about whether your husband should start collecting Social Security benefits. Once he reaches full retirement age, he can get these benefits without having them reduced by his earnings. Full retirement age for him will be something like 66, maybe 66.5. You have to decide whether it is better to get the benefits now or wait to start for a higher monthly benefit.</p>
<p>Does anyone know what happens if a married couple is covered on the older spouse’s job-related health insurance, and then the older spouse goes on Medicare (with or without retiring).</p>
<p>Does the younger spouse, who is not yet eligible for Medicare, lose insurance coverage at this point?</p>
<p>In our case the kids and I were able to stay on the company insurance when my husband went onto medicare. (It may vary by company, I don’t know - your company policy probably details what happens.)</p>
<p>H reached 65 & I got him to finally get Medicare Part A (which was free because he worked long enough). He will have to sign up for Part B & pay a premium when he stops working (is currently working, so doesn’t HAVE to sign up for Part B w/o penalty until he leaves his job.</p>
<p>He has a family medical insurance plan with his workplace that will follow him into retirement & he & I can retain it for the rest of our lives paying our 25-33% share of the premium. It covers me & both of our <26 year old kids (they will age out when they reach 26).</p>
<p>It’s best to have spouse who’s medical plan you are covered under clarify what will happen with medical insurance at milestones like when the covered primary policyholder turns 65.</p>
<p>My understanding is that folks do NOT have to buy Medicare Part B (the one where folks have to pay for the premium) until they separate from their jobs. The premium is $99.90/mo this year [url=<a href=“http://www.medicare.gov/cost/]2012”>http://www.medicare.gov/cost/]2012</a> Medicare Costs, Medicare.gov - the Official U.S. Government Site for Medicare<a href=“more%20if%20you%20are%20above%20certain%20income%20limits”>/url</a>.</p>
<p>The Executive Office on Aging in HI (& likely in most states) has an office called Sage PLUS that will explain the various medicare options to the public at NO CHARGE and with no bias (they don’t sell any plan). They would be a good office to contact to get a better understanding of what to expect for no nasty, expensive surprises (like having to pay higher premiums for your lifetime if you don’t enroll when you 1st turn 65).</p>
<p>HIMom, what is the reason you urged your husband to sign up for Medicare Part A even though he is still working and covered by insurance? I am asking because I’m wondering if I should have my husband do the same.</p>
<p>Part A is FREE, if you worked enough quarters to qualify. It is supposed to be helpful in covering hospitalization costs (which we haven’t yet incurred), but we figured there is nothing to lose, even though H is working. We are deferring having him sign up for part B (which does cost $99.90/month) until he retires, since his insurer covers us quite well. Will have to investigate the different companies offering various plans to choose which Medicare Part B we want. Since his employer’s insurance will continue to offer Rx coverage better than Part D, we don’t need to purchase that & won’t.</p>
<p>Ooh, lucky you HImom. My husbands company continued to offer prescription coverage until suddenly one day they didn’t. His prescription cost jumped hugely once he was on Med D. Unfortunately his company has progressively treated retirees worse and worse over the last few years. I think there should be some rule that companies can’t drastically change people’s coverage after they retire. :(</p>
<p>Yes, it seems EXTREMELY unfair that pension, benefits, insurance and other things that people rely upon get changed after folks retire. The US needs to do more to make sure that these things aren’t eroded and don’t leave retirees high & dry when they are in their twilight years with very few options for generating more income.</p>
<p>Since H’s benefits are from his many decades with the federal government we are fairly comfortable with believing they will not suddenly be taken or greatly diluted, though who knows these days? I am very grateful that he has accrued a comfortable pension and medical benefits–it will be helpful for us & we have relied upon this in planning our future.</p>
<p>Wooooooooooooo…so much to think about! Thanks so much everyone!</p>
<p>I wasn’t aware of the penalty for NOT signing up at 65 until I read swimcatsmom’s link. We need to get going on researching this now! So did I understand correctly that you WON’T be assessed the penalty (increase in Part B premium?) IF you are still working and have insurance through your work??</p>
<p>DH is a physician in a small 5 doctor medical group with @ 30-35 employees. H says that if he goes on Medicare, I am only eligible to buy insurance through the group BC/BS policy for 18 months!?!?! Not sure where an individual (who has 9 years before eligible for Medicare) goes to get insurance!!</p>
<p>As for Social Security, he plans to work a while longer, so he is now thinking he will wait until he is 70 to start collecting benefits so he will get the higher amount.</p>
<p>My understanding is that AS LONG AS you are still working and have health insurance, you don’t have to buy Medicare B without penalty UNTIL Special Enrollment Period (SEP) after you stop working. It appears the SEP is for 8 months duration, beginning the month AFTER employment ends or group coverage ends, whichever happens first. Best to check with your Department of Health, Executive Office on Aging, whatever group helps folks with Medicare to be SURE not to incur penalties when your spouse will be leaving employment or group coverage will be ending. The link I provided above helps with more medicare info–<a href=“http://www.medicare.gov”>www.medicare.gov</a>. It is somewhat confusing & we will have to be sorting this out soon, as H will be retiring in the near future.</p>
<p>Perhaps state insurance exchanges MAY be an avenue to explore for getting medical insurance coverage, though in our state (& probably most), they are still trying to figure things out & don’t currently have insurance for folks to buy. This will be a big issue for others who aren’t covered by insurance.</p>
<p>I’m pretty confused at this point & leaning toward just getting regular Medicare A & B, as well as retaining our federal insurance plan. It seems like it would be fine for us. The person I talked with just now with my insurer says we should be fine with that as well.</p>
<p>MidwestParent- You would be paying for COBRA coverage once your spouse left his group plan. COBRA is limited to 18 months and is expensive coverage (but worth doing). I am paying COBRA right now for H and me even though he is over 65. I expect to have group coverage again soon, but if I don’t he will go the Medicare route and I’ll have to ride out the COBRA until I run out in February.</p>
<p>Cobra coverage IS expensive–my sister has it now & we had to get S some “gap” coverage @ >$300/month when he graduated & was unable to remain covered by his U insurance plan. Fortunately, since he was <26, as soon as H’s plan covered him again, he got back under H’s plan.</p>
<p>My sister will have to have her H purchase medical coverage for both of them when their cobra runs out after having it for 18 months following her quitting her last job that offered medical insurance.</p>
<p>Goodness! Now I am more worried about myself than I am about my husband!! I am 8 1/2 years younger (56 y/o) and haven’t worked outside the home for 27 years. If DH signs up for Medicare, then I can keep the BC/BS through their medical practice for 18 months and it sounds like then I can get COBRA for 18 months. That will get me to 59. What does one do after that???</p>
<p>Since my husband’s ‘business’ is on the small side, we pay REALLY high insurance premiums, so $300 a month does not sound like much to me. Even though we live in a smaller town of 25,000, I think the next step is to see if there is some type of ‘aging office’ here and go talk to them. I will also call our current medical insurance provider (BC/BS) to see what they have to say. </p>
<p>I appreciate all the responses! Continue to chime in if you have any information or experience in this area! We all are going to be in the same boat sooner or later!!</p>
<p>Does his practice SAY it provides for coverage for 18 months and then Cobra? Generally, Cobra is only available when the prior insurance runs out & is capped at 18 months. Agree that you should call your Department of Health. They SHOULD have an executive office on aging that should be able to address some of your questions or point you to where you can get that information. Unless you’re declared medically disabled, you won’t qualify for Medicare until you turn 65. There are an assortment of plans to choose among at that point.</p>
<p>Don’t we have an insurance exchange in 2014 through Obamacare?
I’m in the same boat but DH has 2 insurance in a few years to retire and I can piggy back.</p>