Hello Toni:
I am a HR Manager for a local oil service company and have a question about an employee. He is turning 65 and is still working full time. His situation is a little different because next month he will begin receiving chemotherapy for lung cancer. Not sure how to advise him because technically he is working full-time. He has 5 months of pay from vacation time, which he never used and can use while recuperating that keeps him as a full-time employee.
Our firm has over 100 employees and I’ve been told there are certain rules for a specific company size. How can I make sure that I have the correct answer to my questions for the employees of our company?
…Samantha from the energy corridor area
Hi there Samantha:
Most of the answers about enrolling in Medicare are found in the 2015 Medicare & You handbook on pages 15-34. Some people do not take Part B during their Initial Enrolment Period because they or their spouse are “still working” and they have primary insurance from a current employer. Your employee’s Initial Enrollment Period begins three months before his 65th birthday and ends three months after his 65th birthday.
Medicare and Social Security Advice for HR Departments
As the HR Department, below are a few options, which can help to make your job easier:
- Verify your employees’ options by calling your company’s health insurance plan and ask how the plan coordinates with Medicare.
- It may be to your employees’ advantage to delay Part B enrollment. See page 26 of the 2015 Medicare & You handbook under “Should I Get Part B?” for more clarification.
With other insurance, i.e. employer group health coverage, there are rules that decide whether Medicare or your other insurance pays first. See chart on page 28 of the 2015 Medicare and You handbook.
- If there are 20 or more employeesat the company, where you or your spouse currently work and get benefits, generally the group health insurance pays first.
- If there are fewer than 20 employeesat the company where you or your spouse currently work, and get benefits, generally Medicare is primary. As the HR department, check with your insurance carrier as to how the current insurance plan coordinates with Medicare and verify if your employees should enroll in Medicare Parts A and/or B.
Employees should contact Social Security at 1/800-772-1213 or by the Internet at socialsecurity.gov/medicareonly and inform Social Security that they or their spouses are delaying Part B.
Employees should contact Social Security immediately to enroll in Medicare when their work status changes. They are wanting a SEP (special enrollment period) and should call ASAP when their employment changes from full time to a part time employee, when they decide to retire or are terminated and need to enroll in COBRA. (It is important to remember that COBRA and retiree insurance are not considered current employer insurance. The employee will not have a Special Enrollment Period if they have COBRA or retiree insurance and wait too long).
Confused about Social Security Workshop has been moved to Wednesday September 9th beginning 4:00PM-6:00PM at the Toni Says SW Houston office located at 10998 S. Wilcrest Dr Conference Room, Houston, TX 77099. RSVP to 832/519-TONI (8664)
Toni King is the author of the new Medicare Survival Guide®, which is a simple guide that puts Medicare in people terms and is on sale here. To email questions or to schedule a “Confused about Social Security and Medicare Workshop,” go to Ask Toni … or call 832/519-TONI (8664)
