You’re going to be eligible for Medicare soon.  What do you need to do?

First, know that there are two parts to Original Medicare, Part A (Hospital and inpatient benefits) and Part B (Outpatient benefits).  If you’ve worked and paid into the Medicare/Social Security System for at least 40 quarters, Part A will not cost you anything monthly, while part B will require that you pay a premium.   If you’ve worked less than 40 quarters, there is a charge for Part A, as well.

For most workers, this premium is $135.50 monthly, but your income level may result in a higher billed amount. Medicare looks at your last filed tax return prior to January 1 in the year in which you become eligible for Medicare to determine your income.  For example, for beneficiaries starting Medicare in 2019, they’ll look at your 2017 tax return.  Modified Adjusted Gross Incomes above $85,000 for a single person and above $170,000 for a couple will result in additional premiums for Parts B and D of Medicare (or Medicare Advantage and Prescription Drug plans).  The particulars are explained in this Medicare Brochure:  Premiums for higher income beneficiaries 2019

Before we meet, you’ll  need to make some decisions:

1.  If you’re currently working (or your spouse is currently working) and covered on group insurance, will you want to keep your current group coverage? 

2.  If you’re keeping your group coverage, does your company employ 20 or more employees, or fewer than 20?  This determines if Medicare will be Primary or Secondary.  If you work for a small company, your group insurance may not work correctly without you enrolling in Medicare Part B.  More info:  Medicare Coordination of Benefits – Who Pays First

3.  Does your company offer a “retiree” program of health benefits?  You’ll want to investigate the benefits and your cost to be on the plan before we meet, so we can consider this option. 

4.  If you are not currently covered on a group plan or will be leaving your employer group and know you want to rely on Medicare for your coverage, please sign up for both Medicare parts A & B before we meet.  To do this, you can either call 1-800-Medicare, visit or go into your local Social Security office.  This can be done during the three months prior to your 65th birthday, the month of your birthday, or during the three months following.  Please confirm your effective date for both parts of Medicare AND your Medicare ID number (including the letter or letters at the end of your number).  The earlier you enroll, the more time we’ll have to select your plans!

5.  Those clients who use prescription medication may want us to research the coverage of those medications under Part D and/or Medicare Advantage plans.  If that is your situation, please complete the  Prescription List 2019 and send it to us along with your Scope of Appointment Form.

6.  The US Government requires that all face-to-face meetings with Medicare Beneficiaries occur after you’ve initialed and signed the “Scope of Appointment Form” form.  This should happen  before we meet, and can be sent in to our office via fax, mail, or scan and email.Please call us if you have questions about any of this.  831-335-8200!