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Will You & Your Spouse Be On The Same Medicare Plan?

You and your spouse are probably used to doing a lot of things together. While you were working, healthcare was probably one of the things that you participated in jointly. If you had an individual or employer-based insurance plan, you and your spouse were probably on one plan, which helped you to save money. So now that the time has come to enroll in Medicare, you might be wondering whether you can save money by being on the same Medicare plan. Because Medicare works differently from private insurance, the short answer is no. Medicare plans are issued on an individual basis, so you and your spouse cannot be on one plan.

How Medicare Works

medicare enrollment form with a pen laying on it — *You can delay Medicare Part B if you are working, and then enroll later without a penalty.*

Some people are automatically enrolled in Medicare Part A, and others have to sign up for it manually. In most cases, this depends on whether you’re already receiving your Social Security benefits. If you are 65 and collecting Social Security, then you will automatically be enrolled into Medicare Part A. If you decide to hold off on collecting Social Security, then you will have to manually enroll in Medicare Part A when you turn 65.

Because Medicare Part B has a monthly premium, it is optional; this means you will have to sign up for it yourself during your Initial Enrollment Period (the 3 months before you turn 65, the month you turn 65, and the 3 months after you turn 65). If you do not enroll in Part B during your Initial Enrollment Period, then you will face a late penalty for every year you push off Part B enrollment. If you are still working at 65, then you can opt out of Medicare Part B enrollment without facing a penalty fee, as long as your employer has 20 or more employees.

Both Medicare Parts A and B are plans for one individual person, offered by the government and paid for by the taxes you contributed while you were working. Even if your spouse is already enrolled in Medicare when you turn 65 and enroll in Medicare yourself, your plans will not be connected. As mentioned above, Medicare does not work in the same way as a private health insurance plan, which would allow you to join your spouse’s plan and receive the same benefits. Everyone enrolled in Medicare Parts A and B receives the same benefits; the differences in coverage comes when you choose to enroll in Medicare Advantage or a Medicare Supplement Plan.

Medicare Supplement Plans

money bills rolled up in a rubber band — *Medicare Supplement Plans will help you save on medical expenses based on your individual needs.*

Medicare Parts A and B are individually issued by the government; Medicare Advantage plans and Medicare Supplement Plans are private plans but are also connected to one individual beneficiary. Unlike Original Medicare, though, the coverage they offer differs from plan to plan and person to person. Each Medicare Supplement Plan will have different access to healthcare providers and different networks. What works for one person might not work for another. Because Medicare Part B only covers 80% of costs, many Medicare beneficiaries choose to enroll in a Medicare Supplement Plan to reduce their out-of-pocket costs.

Medicare Supplement Plans are only sold on an individual basis, so you and your spouse will need to purchase separate plans, and may be offered different coverage depending on your needs. If you get a Medicare Supplement Plan through the same company, though, you might be able to take advantage of household discounts. Some companies will offer a discount if one or more members in your household have a plan from the same company.

When Choosing A Plan

Even if you could enroll in your spouse’s Medicare plan, doing so would not provide any extra benefits for you. All Original Medicare plans offer the same benefits, and the beauty of Medicare Supplement Plans is that there are 10 to choose from, so you can get benefits tailored to your needs. But in order to get maximum coverage and to save money, you will have to compare plans and research your options to determine which plan will best fit your financial and medical situation. For example, when looking for a Medicare Supplement Plan, you should talk to your doctors to make sure that they accept Medicare assignment and that they are in each plan’s network.

When you are ready to enroll in Medicare, contact an EZ Medicare agent. We want to make sure you can continue seeing your doctors, getting your medications, and being treated for any conditions. We also want to make sure that you can save money while doing so! We will research all possible options in your area and provide you with quotes so you can make an informed decision for your healthcare needs. All of our services are free, and there is no obligation to sign up. We want to help you get covered! To compare plans in minutes, enter your zip code in the bar above, or to speak to a licensed agent, call 888-753-7207.

Are Humana & Medicare The Same?

Many people wonder if Humana and Medicare are the same. Simply put, no. Medicare is a government administered health insurance program, and Humana is one of the largest private insurance companies. People get these two confused because Humana sells Medicare Advantage and Medicare Supplement Plans. Let’s go over what exactly the two are.

a picture of a balancer with green apples on onse side and oranges on the other. — *When comparing Medicare and Humana, it can be like comparing apples and oranges. They are two different things.*

Medicare

Medicare is the nation’s largest health insurance program for adults 65 and older. It is operated by the Centers for Medicare and Medicaid Services (CMS) under the US Department of Health and Human Services (HHS). Medicare is used by over 57 million Americans, and it is not based on income, and it is not free. In order to be eligible for Medicare, you must meet some requirements:

You must be 65 and older.
You must have worked and paid at least 40 qualifying quarters, or 10 years, of Medicare taxes to receive Medicare Part A.
You must be a U.S. citizen.

Medicare benefits are divided into two parts, Part A and Part B.

picture of different medical equipments — *Medicare Part A and Part B covers a number of hospital and medical services.*

Medicare Part A (Hospital Insurance) — covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care, and some home health care. (100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility.)
Medicare Part B (Medical Insurance) — covers annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.)

Medicare will cover 80% of your Part B expenses, leaving you with 20% to pay out of pocket. If the expenses get to be too much to budget, you can look into additional coverage to pay for the 20%, such as Medicare Supplement plans. These plans vary by premium, deductible, and coverage. Additionally, they are helpful to those who travel, as some cover international health care costs.

Humana

Humana is a private insurance company that sells Medicare Advantage plans, and Medicare Supplement plans for people looking for secondary insurance to help pay for Original Medicare.

Humana is contracted with the federal government to provide these Medicare plans under the Medicare program.

If you have Medicare and are interested in a Medicare Supplement plan, EZ.Insure can help! There are roughly 10 different types of medicare supplement plans on the market, and they all vary in coverage and cost. Figuring out which plans are best for you can be hard, but we are here to help. If you would like to gather more information on Medicare and Medicare Supplement plans, one or our highly trained agents are ready to help.

You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at [email protected] or call 855-220-1144. There is no hassle and no obligation. We will help you answer any questions, go over all of your plan options, find the Medicare Supplement plan most suited for your needs and budget, and even help you sign up if you’re ready.

Congress Considering Bill To Eliminate Gaps In Coverage

If you are turning 65 soon you might be looking for information on your Medicare eligibility, and what exactly having Medicare means. Medicare provides insurance to seniors under plans known as Parts A and B. Part A is hospital insurance, and Part B is medical insurance. While Part A is free, Part B is only covered up to 80% by Medicare, leaving you to pay for the other 20%. Unfortunately, some people are unaware that they must sign up for Part B within a certain timeframe, and can face a Medicare penalty.

white bell insude of a blue circle. — *In order for Medicare beneficiaries to avoid a penalty, Congress will begin notifying them to sign up before they turn 65.*

Currently Medicare does not notify you when it is time to sign up and it is up to you to be aware of the standard enrollment periods. If you do not sign up for Medicare Part B within the specified enrollment period, then you will face a life-long penalty. Luckily, in order to help people avoid this penalty, Congress is considering making revisions to a bill called the BENES Act.

The Medicare Penalty

Medicare Part A normally kicks in when you turn 65 on its own, there is no action required from you. You can enroll in Part B three months before you turn 65, the month you turn 65, and three months after the month you turn 65. While it is mandatory to enroll into Medicare Part A when you turn 65, you do have the option to opt out and put off your enrollment into Part B. Generally this will cause a penalty to be applied to your future Medicare rates unless you qualify for a special enrollment period.

The qualifications for a special enrollment period are:

You have coverage by a group health plan through you or your spouse’s current employment.
During the 8 months following the month your group health plan coverage ends, or when the employment ends (whichever is first).

If you do not qualify for a special enrollment period, then you will only be able to join during The General Enrollment Period, or GEP.

The GEP, which falls between January 1 and March 31 of every year, is the period of time when you can enroll in Medicare Part B for the first time. Coverage will then begin the following July. However, if you skipped the initial enrollment period when you turned 65 and waited for a GEP, you will be at risk of facing a penalty.

dollar bills piled on top of each other. — *If you miss the opportunity to sign up for Part B when you are eligible, you will face a 20% penalty for every year you did not sign up.*

When you do decide to finally sign up for Medicare Part B, you will then have to pay an additional 10% on top of your monthly premiums. For every full 12-month period (calendar year) that you were eligible for Part B, but did not enroll in it, you will pay a 10% penalty for as long as you have Part B. For example, if you opt out of signing up for Part B benefits for two years, then you will face a 20% penalty fee added onto your monthly Part B premiums forever.

The Problem

Unfortunately, some seniors mistakenly assume they can skip Part B because they have a former employer’s insurance through the ACA, or for other reasons. This leads to the beneficiaries facing a monthly Part B penalty for the rest of their lives. According to research, in 2018, about 760,000 people were paying a late penalty onto their monthly Part B premium, increasing their costs an average of nearly 30%. Congress thankfully is stepping in to try and end the Medicare penalty by notifying the beneficiaries before they turn 65.

Congress’ Approach

Congress hopes to revise the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, so that Medicare & Medicaid Services are required to notify people before their 65th birthday about their Medicare eligibility. Currently, the government only contacts people who are receiving Social Security benefits to notify them when it is time to sign up for Medicare.

The hope is that this would lead to beneficiaries avoiding the Part B penalty when they do not sign up for 12 or more months after they become eligible.

If passed, the revision would be the first one in five decades. This would move the GEP (January through March) window to the fall, which would coincide with the enrollment period for drug coverage and Medicare Advantage. It would also do away with the July effective date, and move it to January.

Medicare Isn’t Mandatory, But There Is A Penalty

Medicare normally kicks in when you turn 65. You can enroll 3 months before you turn 65, the month you turn 65, and three months after the month you turn 65. While it is mandatory to enroll when you turn 65, you do have the option to opt out and push your enrollment into the program. However, when you do this, you are at risk of facing a penalty.

caucasian hand holding a bubble with a stethescope in it — *There are some ways to avoid the Medicare penatly, such as if you have employer’s health insurance.*

Having Coverage

If you are still employed, or have coverage, then you can opt out of signing up for Medicare. As long as your employer has 20 or more employees, then you can hold off on Medicare, and will not have to worry about the penalty. You can still sign up for Medicare Part A. It does not cost you anything and will cover hospital visits, and can act as a secondary insurance to your employer’s insurance.

Collecting Social Security

If you are collecting Social Security, then you will automatically be enrolled into Medicare Parts A and B. You have the option to cancel or opt out of Part B if you have coverage through an employer. However, if you opt out, then you will face a penalty. Medicare Part B covers doctors’ services, outpatient care, and medical equipment.

The Penalty

Opting out of Medicare Part B without a valid reason, such as being on an employer’s insurance, then you will pay a penalty fee. When you decide to finally sign up for Medicare Part B, then you will have to pay 10% to your monthly premiums. This penalty can remain as part of your monthly premiums for a long time.

Every full 12-month period (year) that you could’ve had Part B, but did not take it, you will pay a 10% penalty for as long as you have Part B. For example, if you opt out of signing up for Part B benefits for 2 years, then you will face a 20% penalty fee added onto your monthly Part B premiums forever. If you opt out for 4 years, then you will face a 40% penalty, as so forth.

caucasian hands holding open an empty wallet — *The Medicare penalty you will face is 10% for every year you opted out of Medicare.*

When You Are Safe From Penalties

If you miss your enrollment date, you have a General Enrollment Period, GEP, in which you can sign up if you missed signing up when you were eligible. It is a make-up time for Medicare enrollment and us January 1-March 31 every year. If fewer than 12 months have elapsed, then you will not pay a penalty fee. Other situations you can avoid the penalties are:

If you have Medicaid and Medicare. The state pays the Part B premiums.
If you qualify for assistance from your state in paying Medicare costs under a Medicare Savings Program.

It is not mandatory to sign up for Medicare when you turn 65, depending on your situation. If you do not sign up when you are supposed to, then you will be penalized, unless you have employer coverage or are in the aforementioned situations. It is best to go over your situation and make sure you are making the best decision. Talk to a Medicare agent beforehand so that you are aware of all of your options, and how you can avoid any extra fees.

EZ.Insure can help you with these kinds of situations. We offer specialized Medicare agents within your area that can go over all of your options and make sure you are in the best situation. If you would like to speak to an agent, call 888-753-7207 or email us at [email protected]. Or if you would like an instant quote, enter your zip code in the bar above. Our services are free, because our goal is to help you, and make sure you are taken care of.

Wait! Before You Drop Medicare For Employer’s Healthcare Coverage Read This!

It is more common for retired seniors to work. Almost 27% of people aged 65-74 are in the workforce, and the projected stats are rising. Some seek extra money, while others do it to pass the time. When you turn 65, you are enrolled in Medicare Parts A and B. If you decide to go back into the workforce, you can opt to drop Medicare Part B coverage and expenses. Coverage of the benefits you receive from Part B will be replaced with the employer’s group health insurance. You can always opt to go back to Medicare at any point, but there will be some repercussions if not done at the right time.

What Medicare Covers

Medicare coverage is divided into two parts, Part A and Part B. Medicare Part A covers hospital care, and is usually free as long as you meet the Medicare guidelines: working at least 10 years before age 65, and being a US citizen. Medicare Part B covers outpatient care, including annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.) The monthly premium for Part B is

Clock with coins in 3 rows next to it growing with a green leaf sprout on each row. — *HSAs come with a triple tax benefit, but any contributions are tax-deductible.*

$135.50 for 2019. The cost might be higher depending on income..

What Employers Offer: HSA Plans

Employer’s offer health insurance coverage, and usually a health savings account, HSA, as well. If you are on Medicare Part A, you cannot make any contributions to an HSA. The employer’s coverage is considered a “high-deductible” plan. HSAs come with a triple tax benefit, but any contributions are tax-deductible, and withdrawals are untaxed as long as it is used for qualified medical expenses.

How It Will Cost You

If you drop your Part B plan for an employer’s plan, you can always sign up for Part B again during your Special Enrollment Period or SEP. This period is when you leave your employment, or the employment loses coverage. If you miss the 8-month SEP, you face a late-enrollment penalty, 10% of Part B’s monthly premium for each full year you should’ve been enrolled.

If you drop Part A, you might have to repay the government for any medical services under Medicare that you used. Also, if you collect social security, you will need to repay that back also.

Caucasian woman;s hand holding a pen ready to write on an openedbook with the page titled "my plan." — *If you drop Medicare, returning can be difficult, so think carefully and explore your options completely before making a decision.*

Some seniors buy a Medicare Supplement plan to support their Medicare Part B expenses. When you drop Part B and sign up for your employer’s coverage, then you will also have to drop your Supplement plan. If you decide to go back to Medicare Part B, buying a Medicare Supplement plan will not be as easy. Your coverage could be denied due to pre-existing conditions and health status.

If you plan to drop your Medicare and use your employer’s health insurance plan, it can cost you in the long run. Your decision should be based on how much your employer’s plan costs, your out-of-pocket expenses in a high-deductible plan, and your budget. If you drop Medicare, returning can be difficult, so think carefully and explore your options completely before making a decision.

Tag: medicare part A