Enroll in Medicare the Correct Way!!
Dear Toni:
I am retiring in February when I turn 65 and will need to enroll in Medicare Parts A and B with a Medicare Supplement and a Part D prescription drug plan.
My husband, James, is 72 and has heart issues so, he enrolled in Medicare A and B when he turned 65and remained on my company benefits to have his heart surgery. He is taking Eliquis for blood clots.
James needs to apply for a Medicare Supplement because his cardiologist’s office manager expressed concern over my husband’s insurance changes since their office is accepting a few Medicare Advantage plans. She suggested that Medicare with a Medicare Supplement would be his right option.
Please explain what I need to do to get Medicare Supplement coverage for both me and James. We need your help. Thanks, Paulina –Mobile, AL
Hello Paula:
America does not realize how confusing it is to enroll in Medicare when retiring and leaving employer benefits. When you enroll in Part B the wrong way, it can cause you to not qualify for the Medicare benefits you desire whether it’s a Medicare Supplement with a stand-alone Part D prescription drug plan or a Medicare Advantage Part D plan.
Medicare provides special rules for employees or spouses who are “still working” with “true” company benefits and are covered by the employer group health insurance.
Paulina, you are in your Medigap Open Enrollment Period and on page 75 of the 2025 Medicare & You handbook it states, “The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. During that time, you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the first month you have Medicare Part B (Medical Insurance) and are 65 or older. After this 6-month period, you may not be able to buy a Medigap policy due to health issues. If you’re able to buy one, it may cost more.”
Paulina, you can have your Medicare Supplement plan G with a Part D prescription drug plan begin Feb. 1when your Medicare Part B starts without answering one health question
Your husband, James’ Medicare situation is different because he enrolled in Medicare Part B when he turned 65 over 7 years ago. Now he must answer underwriting questions to qualify for a Medicare Supplement.
That’s why enrolling in Part B the correct way and at the right time, when an enrollee or spouse is “still working” full-time with true company benefits is important You also want to be accepted by a Medicare Supplement/Medigap plan due to your age and medical issues.
Good news, Pauline, because James’ saving grace, for bad underwriting, is that James and you are leaving your employers benefits. He will receive a 63-day “guaranteed issue” period to apply for a Medicare Supplement/Medigap plan. Keep the employer benefit termination letter to show the Medicare Supplement insurance company that James is in a Guaranteed Issue Period.
According to your rights under the Guaranteed Issue Period an insurance company must:
- Sell you a Medigap/Medicare Supplement policy. “You have the right to buy a Medigap/Medicare Supplement plan A, B, C*, D*, F*, G*, K or L that’s sold in your state by any insurance company. (Plans C & F are available to those who were eligible for Medicare before January 1, 2020. Plans D and G are eligible for those new to Medicare on or after January 1, 2020.)
- Cover all your pre-existing health conditions.
- Cannot charge you more for a Medigap/Medicare Supplement policy, regardless of past or present health problems.
No one realizes the value of first receiving Medicare Part B until they are in James’ situation. They apply for a Medicare Supplement learning they may not qualify because they are no longer in their Medicare Open Enrollment period. James can only qualify for Medicare Supplement F. He will not qualify for Plan G because he will have to pass health underwriting to qualify.
Email info@tonisays.com or call 832/519-8664 with your Medicare questions.
