Medicare Part D Extra Help

Do you qualify for Low Income Subsidy (LIS) or Medicare Part D Extra Help?  If you have limited income and resources, you may qualify to get help to pay for the Medicare Part B premium and/or reduce your copays and deductible on your Part D plan (prescription drug plan) or the Part D portion of your health plan.  If you qualify for Part D Extra Help, then you also have a year round open enrollment period, which allows you to enroll into a different drug plan or Medicare Advantage plan that has drug coverage.   Check with us to see if you qualify and if you do, then we can review your current plan to see if you are on the best plan for you.


Part B Penalty


Medicare Insurance: Thinking of staying on Cobra because it’s easy, you know it, or maybe you have a spouse that’s under 65 and they still need coverage?  Think again! Avoid the Part B Penalty! If you are eligible for Medicare and you are planning on retiring, be sure to follow the correct guidelines or you may be penalized by Medicare.  Once you leave your employer group plan, and you are eligible for Medicare, you must take out Part A and Part B and pick up a Part D (drug) plan.  Medicare gives you 8 months from the time you leave your group plan to get Part B in place, and this gives you a Special Enrollment Period which allows you to enroll in a Medicare plan.  [You should have signed up for Part A when you turned 65, but if you didn’t, then you need to get that too.] If you pass this 8 months, then you cannot enroll into Part B until Medicare’s General Election Period, January 1st through March 31st and that will give you a Part B effective date of July 1st.  Then you can add additional coverage effective July 1st also.

Part B Penalty:   If you fall into the above situation and you end up taking Cobra, this is not considered creditable coverage, and you’ll have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it.

Under 65 Individual Health Insurance:  If you are under 65 and you go on a Cobra plan, in most cases you will be fine and you will not have any penalty.  This is considered creditable coverage under the ACA (Affordable Care Act) guidelines as long as that Cobra plan meets the ACA requirements of minimum essential coverage.  Most Cobra plans meet these guidelines, but if you are concerned, just ask the Cobra Administrator to verify this and they can advise you.  Be aware though, if you are mid-year and outside of open enrollment, and you decide to get off the Cobra plan, you cannot do that until the Open Enrollment period comes around again.  Open Enrollment is November 1, 2017 – January 31, 2018.  Cobra extends your coverage for 18 months and if you’re offered Cal-Cobra you have another 18 months.  If you have either of these situations and your coverage runs out mid-year, then you will be able to get coverage through an individual plan or through Covered California because you’re not choosing to leave the plan, you are losing coverage.  Basically the coverage has run its course and is ending. This gives you a Special Election Period and allows you to purchase new coverage within 60 days.  If you miss the 60 day window, then you will get a penalty.   




Me & Erin Brockovich!


Recently I was invited to the 2016 AARP recognition event in New Mexico, I was being recognized for my community service hours. I had the pleasure of meeting Erin Brockovich , who is a Consumer Advocate and a Legal Crusader who thrives on being the voice for those who don’t know how to yell!  What a wonderful woman!  You might remember the movie that Julia Roberts starred in as her, “Erin Brockovich”.  It was a great experience meeting some fabulous people.   Some things I was able to take away from this trip;  how to take responsibility, have respect for others, the environment and yourself and last but not least to take time out for your loved ones and as well as yourself!


New to Medicare?

Are you just turning 65 or just now retiring? You might be feeling a little overwhelmed if this is your first time looking at Medicare and how it works.  While there is a ton of information out there, it is still very confusing when you’re first learning about it.  First you need to enroll in Medicare, a few months prior to turning 65, or if you’re collecting Social Security, you will be automatically enrolled and your card will be sent to you.  Once you get enrolled in the Medicare system, then you can purchase either a Medicare Advantage plan or a Medicare Supplement and a Part D prescription drug plan.  If you’re not sure which way to get coverage, you can ask an Insurance Agent for help to guide you through this process.

At 65 you can enroll in Medicare for the first time. Your initial Enrollment Period (IEP) for a Medicare Advantage plan or Prescription Drug Plan (Part D) starts three months before your 65th birthday, includes your birth month and ends three months after your 65th birthday. You have a total of 7 months to enroll into one of these plans. After this time frame is over, you can’t enroll any other time during the year until the Annual Enrollment Period, at which time you can then make a change or enroll into a new plan.  Give us a call to help you determine which plan is best for you.  We’re here to help and don’t cost you anything!