Welcome to Medicare School Daily, where we help you understand Medicare, save money,
avoid mistakes, and above all else, get the most out of your Medicare benefits.
I've been in Medicare business a long time, and have literally fielded tens of thousands
of questions, and one of the most common questions we get asked is this one right here:
Should you start Medicare A and B at age 65?
Well, the answer really depends upon your situation.
So you have to know the answer to this question.
Are you or your spouse still working?
And if you say to me that you are no longer working or your spouse is no longer working,
which means you don't have a group plan available, the answer to the question, should you start
Medicare at 65 is, you must start in 65.
You have no other options.
Unless you or your spouse are working,
you have to go on Medicare.
Now, if you're receiving Social Security, they're going to mail you your Medicare card
A and B automatically, just shows up in the mail about 100 days prior to when your Medicare
begins on your birth month.
OK? But if you're not on Social Security, then you're going to have to initiate that
enrollment and go ahead and enroll yourself into Medicare.
But let's say you answer yes to this.
Maybe you're still working or maybe your spouse is still working.
And so you say yes to that question.
And so the answer is, should you go on Medicare A and B?
And the real answer is, well, maybe. Maybe. Maybe not.
In order for you to decide whether you're going to go on Medicare or should go on Medicare,
there are some things that you have to look at.
First of all, you're going to have to make a comparison between your group plan versus
what your Medicare options are. In order for you to evaluate this decision,
you have to know, first off, what's your premium.
What's it cost to you to be covered by the work plan?
In other words,
What is coming out of your check?
I know your employer's paying for some of it,
you're paying for some of it as well, but you're typically payroll deducted.
So what's your premium on a monthly basis?
What's your deductible?
Some people have low deductibles, maybe $500 or $1,000.
Some have very high deductible, maybe $5,000 or $10,000.
So you have to meet a deductible before the plan begins to pay.
So how high is that?
And then lastly, Max out of pocket for the year.
That means that if you got some serious diagnosis, you've got cancer,
maybe a hip replacement or something like that.
You had to have open-heart surgery.
Those are very expensive needs.
And so what would be the most you'd spend for the year?
$2,000?
$5,000?
$10,000?
It varies plan to plan, but you have to know what you're max out of pocket is going to
be if something seriously happens.
And so these are the details that we need to know for you to better evaluate that particular
decision.
Now, there are two things that you need to know about your premium.
If you're married to someone that's also Medicare eligible,
you want to know what's the premium
if you did employee only, or if you did employer plus spouse.
Right?
And so you need to find that out for premium. In fact,
we just had this happened recently, had a lady, husband and wife both turning 65
going on Medicare.
The employee only price for her was $100 a month.
But to add her husband was $550 a month.
And so it cost her $450 to cover her spouse, who is also Medicare
eligible.
So what she decided to do, very wisely, is she took the employee only plan, paid $100
a month and put her husband on Medicare.
All right.
So those details need to go into this decision.
And then there's a couple of other items that you need to consider.
Number three, here, we have one rule of thumb that we would suggest you be mindful of, and
that's this.
If you are spending out of your pocket for premium $250 a month
or more, $250 and up, then it's probably in your best interest to go on Medicare because you're
just paying too much for the group plan.
Again, I said probably, but that's kind of our rule of thumb.
Someone says to us, you know, I'm only paying $50 or $100 a month and it's
a pretty good plan, then probably going to stay right where you are on the group plan.
But if you're spending $250 a month or more, either for you, or your spouse or both, then probably
going to be in your best interest to look at Medicare as an option.
All right.
And then fourthly, here in lastly, we have two very important cautions.
If your group plan has coverage for your spouse, right, that is younger. Younger. And your younger
spouse is no longer working; is covered by that plan and really has no other options,
then you going to Medicare is probably going to affect him adversely. Or if you have children.
Remember, children can be covered up until age 26.
So you have children that are below the age of 26,
then it also may impact them negatively by you going in Medicare because they're going
to lose their coverage as well.
So those are the cautions.
And then lastly is this, if you are taking expensive medications, that could be let's
suppose you're an insulin-dependent diabetic and you're taking Novolog or Humalog or Lantus,
and you're using the quick pens.
Those are very expensive.
And so you want to compare what your co-pays are on the group plan versus what your co-pays
would be with Medicare, because sometimes Medicare costs for those kinds of
medications are more expensive.
So that's going to hurt you financially by getting off the group plan, again
not always, but sometimes. But expensive medications can also cause you to stay on that particular
group plan.
So these are the things that you're going to need to consider before you can answer
this question:
Should you start Medicare A&B at 65?
For some of you, that's a good move.
Others of you, need to
stay right where you are on the group plan.
Thanks for watching.