Medicare Gotcha’s and Things to Know
Turning 65 Decisions
Once you enroll in Medicare Part A (hospital insurance), you can no longer contribute to a Health Savings
Account (HSA).
When you have both Medicare and COBRA, Medicare generally pays first, and COBRA pays second, acting as secondary coverage, unless you have End-Stage Renal Disease (ESRD), in which case COBRA pays first for the first 30 months, then Medicare takes over. The key is that COBRA is an extension of
your prior group health plan, so the rules for that plan when you were working determine the primary payer, but for most people, Medicare becomes primary
If you work past 65 and enroll in Medicare, it is important to know which plan pays first. If you work for a company with 20 or more employees, your employer plan pays first (primary), and
Medicare pays second; if your employer has fewer than 20 employees, Medicare pays first (primary), and the employer plan pays second.
Once You Are Enrolled in Medicare . . .
If you move in state or out of state, your Medicare supplement goes with you, but your Advantage plan and drug plan may not. Over 98% of providers nationwide participate in
Medicare. Advantage plans use small provider networks with fewer choices, so you'll likely need to use doctors within that specific plan's network, which can be smaller than the overall pool of Medicare-accepting providers.
MA plans often limit you to specific doctors and hospitals, which can be a problem if you travel often within the
country.
Notify SSA of your new address as soon as you are settled. You should also tell your Medicare supplement carrier about your move.
Original Medicare + supplement
(Medigap) does not impose network limitations and restrictions. You have unfettered access to providers that accept Medicare.
You OWN your Medigap plan. It cannot be cancelled except for non-payment of your premium. MA plans do not renew. Every year
your current plan terminates on 12/31 and a new plan on January 1. Participating providers can change during the year as well as from year to year. MA deductibles, copays and maximum out of pocket can change.
If you join an MA plan and later switch back to Original Medicare, you might not be able to buy a Medigap (supplemental) plan
if you have health issues. There is only ONE Medigap open enrollment period where you may purchase any plan you want without proving you are an insurable risk. That period starts the clock when your Medicare Part B is effective and ends 6 months later.
When you travel out of the country, original Medicare has very limited coverage. Always
consider an international travel medical plan. The only travel medical plan we recommend is Blue Cross Blue Shield Global SolutionsSM. Please use this direct link to review and price plans plus enroll.
https://bcbsglobalsolutions.com/individuals-and-families/?link_id=160173
Feel free to contact me if you have questions.
Driving through a small town . . .
