Welcome to Medicare school Daily where we help you understand Medicare, save money, avoid
mistakes, and above all get the most out of your Medicare benefits. Now today's topic
is this question here, "how do you begin Medicare benefits if you recently lost your job?" By
the way I hope this doesn't happen to you but if it has I know Medicare can be confusing
and sometimes a little intimidating. So we are going to show exactly what you have to do
if you've lost your job. Number one is, I address the topic. I want to share some quick assumptions
with you. First off I'm assuming that you are above 65. You're either 67, maybe
79, 83, whatever, but you're above 65 - which means you no doubt have already
enrolled into Medicare Part A only. A lot of people take part A and not part B and they
do that at 65 as they continue to work. And the other thing I'm assuming is that you have
no other insurance options, which means you're no longer working there and you don't have
other employment lined up somewhere else. And so you have no other insurance options.
Or your spouse is no longer working either, so there's no insurance option available whatsoever.
So we're going to have to go on Medicare. Now Medicare coverage always begins on the
first of any month. You don't start Medicare in the middle the month, you start in the first
of whatever month that you're going to enroll. So they'll start you the next month. So
if I enroll this month, I'm going to start the next month on the 1st and that's the way the
system works. So that's number one.
Present coverage. Number two: Medicare allows you to come into Medicare to start
your benefits at different times. We call these enrollment periods. Now someone that
comes into Medicare right at 65 uses an enrollment period called the initial enrollment period.
Well clearly you're beyond 65, you're 67, 69 or beyond. So initial enrollment period is not
available to you. The enrollment period you're going to use is called the special enrollment
period. So this is for anyone coming into Medicare that was working at 65 and now they
have lost that coverage. So they could be 65 1/2 or 67, but they're beyond
65. We use the special enrollment period, which has the acronym SEP. Now as you read about
the special enrollment period, you'll notice that this special enrollment period lasts
for 8 months. And what that means is that once the employer coverage is ended, you have
8 months to come into Medicare and that is true. However, what you need to know about those
8 months is this: Let's suppose you've lost your plan at work, you're not on Medicare
yet, and you have some kind of a large claim.
In other words, there was some health issue happens, and you really don't have any insurance yet.
You are going to have problems. So let me explain how this works when it comes to Medicare
eligibility and other insurance. All right? So let's suppose that you're still working.
I know you're not, but let's suppose that you work and you happen to be enrolled in
Medicare. A lot of people do that today. In this situation, the employer is going to pay
first. You're still working. Employer pays first. Medicare is going to be in the second
payer position while you're still working. Those are just the rules. But again you're
no longer working. Employment is ended. And if you're not working what happens, now Medicare
is going to take the first payor position. And whatever insurance you have beyond that,
could be Cobra, Could be retirement plan, maybe a supplemental plan. These are always going
to pay second to Medicare. So if you've lost your job and if you're gonna be covered by
one these kind of plans, you have to enroll into Medicare to put them in the first payor
position. So even though you have 8 months to do that, once that employer position ends,
if you have their insurance it's over here. And so you have to get enrolled in Medicare
to make sure they're first. Because here's what happens, if you don't enroll into Medicare,
Once your coverage is ended, Medicare is not here. You know who's here? You are.
So all of a sudden you're in the first payer position; you're liable for all those bills
and you don't want to be in that position once so that's terrible. And so that's what we're
saying. Once it ends we're going to go on Medicare. So once my employer plan ends June
30th I'm starting that Medicare July 1 11/30, I'm going to start at 12/1. All right?
So we're going to come into Medicare using the special enrollment period. Now the process
of coming into a special enrollment period is different. So let's talk about the process. First off
there's some documentation that we have to have to get to Medicare, so we'll do this through
a local social security office. And there's actually two forms. One is called the L564 and one
is called the 40b. So let me explain these documents. I'm gonna show them to you as well; I know you can't see them,
but I want to make my point this way. This is a one page document. This L564 is filled out
by your employer typically through the H.R. department. And what this is for. It'll be
the name address the employer your name and address and Social Security number. And the
H.R. is going to verify that you have had employment as well as insurance all the way
back to 65.
So if you just lost your job and you're 69, we're going to have to go
all the way back to 65 and we're going to have to prove to Medicare that you have had
credible insurance coverage during those four years. So you're 67. What do I have to do?
Again, I'm going to go back to 65 to prove that we've had credible insurance. Now there are times
when people change jobs after 65 so let's say we change jobs somewhere in here. We're
going to have to have this document from this employer as well as this employer because
we have to have every month covered. We have to prove to Medicare that you've had credible
coverage every single month all the way back to 65. OK? So that's part of the process. And
so these documents need to get to the social security office, and we recommend if you can
go to a local social security office and personally deliver those. If you can't, you can fax these
in or you can mail them in. We'd like you to go personally because they typically don't
get lost that way. All right? But they have to go to the local office. Now, if you don't
know where your local office is, they have a Social Security office locator. You can put your
zip code in the SSA.gov and they'll tell you what office you need to work through.
All right? And so that's the process of getting enrolled during the special enrollment
period. And then lastly there is a possibility that you may go back to work. Meaning, you just
lost this job but you may find another job, and that job may have benefits. And if that
happens to you it is fine because what could happen is we would recommend that you stay
in A only. But when it comes to B, you can actually terminate B, and there's a very simple
paper that will do that. You can turn that in and you can actually drop off the B. So
if you do find another job or maybe your spouse finds a job and you have benefits; even though
you've already enrolled in Medicare you can actually terminate the Part B if you get other benefits
through an employer-provided plan. So it's fine, but right now we need to go on Medicare.
And again if we get reemployed then we can drop off that coverage. So this is the process
that we use to get into Medicare A and B if we've lost our job. Now most of you know
that beyond Medicare A and B there are other insurance products that will be necessary.
Those plans are called supplemental plans, Advantage plans, as well as prescription drug
plans. And so you're gonna choose this other insurance coverage to reduce your risk.
So if you go to Medicareschool.com, you'll find a lot of great information
about all of those types of plans, and we will help you to decide what's going to be your
best coverage beyond just A and B. Thanks so much for watching.