The woman was about to turn 65, and friends had given her conflicting advice about Medicare. She made an appointment with a counselor through Senior Health Insurance Benefits Assistance to ask some questions.
She said one friend had told her to enroll in Medicare only, what’s called Original Medicare. Another friend had said no, enroll also in Medicare insurance.
The counselor told her either was a worthy option, and offered a third.
Because the woman had health insurance through her spouse’s employment, she could defer Medicare Part B and its $148.50-a-month premium until losing the spouse’s insurance. After checking that Medicare accepted the employer insurance as “creditable,” she chose to defer Medicare Part B.
As a result, over a year’s time she will have saved nearly $1,800.
If you would like to make a counseling appointment, or to ask a question to be answered here, please see the end of this column.
Q: I will start Medicare in a couple of years when I turn 65. I’ve been looking into insurance, have settled on Medigap supplemental insurance. I’m in really good health, so I’m thinking of getting a less-expensive policy (such as Plan M) and moving up in benefits and premiums as I age. A worthy strategy?
What you describe sounds reasonable, but it’s prohibited. With Medigap supplemental insurance you can move to a lesser policy, but you cannot move up to a stronger one. For example, if you were to initially enroll in Plan M you would later have the option to move only to another Plan M policy or to a Plan N policy. By contrast, from a Plan D policy you could move to seven policy types, and from a Plan G to any other available policy. Plans C and F are no longer sold to new Medicare beneficiaries.
See the Oregon birthday rule fact sheet. The first page explains your rights in moving from one company or policy type to another, and the second page shows how one may move from one Medigap supplemental policy to another.
Q: My husband has Medicare. He’s 63, has had Social Security disability benefits for six years, and is covered by my work insurance. We’ve decided he would benefit from having Medicare supplemental insurance. Considering his disability, how much more would that cost us?
A two-part answer. First, without a pre-existing condition, his monthly premium for Plan G supplemental insurance, also known as Medigap, would be about $125, not including separate insurance for prescription drugs. To obtain a premium quote, contact the insurance company. It would presumably send him a questionnaire to complete so it could figure his premium.
Second, when he qualifies for guaranteed issue, he won’t have to pay a higher premium because of a pre-existing condition. He will have guaranteed issue when he turns 65. He would also have it if he were to lose your employer insurance (if, say, you were to change employers or retire). In either event he would have limits to how long he could wait to enroll, so be sure to check.
Q: If I crash my car I would expect my insurance rate to go up. If I have expensive surgery, can I expect my Medicare insurance to raise the premium?
No, premiums for Medicare Advantage and Medigap supplemental insurance are unrelated to the claims experience of an individual with that insurance. Premiums will usually be influenced, at least in part, by the aggregate claims experience of the community of Medicare beneficiaries enrolled in that insurance, however.
Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance program. To ask a question to be answered in this column, e-mail [email protected]. To schedule a free SHIBA phone appointment with a volunteer Medicare counselor, call 800-722-4134.
