Volunteer Medicare counselors talk with hundreds of Salem-area Medicare beneficiaries each year, usually with good outcomes. But occasionally the results can only be described as temporarily disappointing.
This individual had turned 65 several months before, and had elected to skip Medicare enrollment because he had health insurance through his employer. What he had missed, though, was that his employer was among those that terminate coverage when an employee becomes eligible for Medicare.
He was now uninsured, and made an appointment with a Senior Health Insurance Benefits Assistance (SHIBA) counselor to ask what he could do.
The fellow remembered having received a letter from his employer, but said he hadn’t read it carefully, hadn’t saved it and didn’t know what it said. Presumably it alerted him that, with Medicare eligibility, his employer insurance would end.
As a result, the man had to wait until the beginning of this year to enroll in Medicare, and even then his Medicare – and his ability to have Medicare insurance – was delayed until July 1. He may also face lifetime late-enrollment penalties.
The SHIBA counselor described how to proceed with Medicare enrollment, outlined the array of Medicare insurance options, and offered to assist when the person became eligible to enroll in insurance.
If you would like to make a SHIBA appointment, or to ask a question to be answered here, please see the end of this column.
I’m 73, am fortunate to have no serious medical issues, and am curious what Medigap insurance would cost me.
A most interesting question. Because you’ve had Medicare for more than six months, before enrolling in Medicare supplement (Medigap) insurance you would be asked a series of health-related questions. The insurance company would use your answers to decide whether to sell you a policy and, if it would, then how much your premium would be.
Let’s assume that you have no medical condition or history that would concern an insurance company. For purposes of finding a premium we’ll put you in the 97306 ZIP code, assign your gender (male), age (73) and stipulate that you don’t use tobacco.
For the strongest policy available to you, Plan G, the monthly premiums vary by as much as $170. The two lowest premiums are $147 (one company) and $184 (two companies). If you were to instead choose Plan N, the two lowest monthly premiums are $135 and $146. To see a grid of how various Medigap policies’ benefits compare, see pages 38-39 of the 2022 Oregon Guide to Medicare Insurance Premiums.
A SHIBA counselor could obtain premiums for any Medigap policy sold in Oregon. An insurance broker who handles Medicare supplement policies could obtain premiums for any company the agent represents.
I know Medicare has penalties in certain circumstances but, really, how many people have these penalties?
As you know, the possible penalties are for late enrollment in either Medicare Part B or in prescription drug insurance.
The April issue of a Kiplinger’s newsletter reported that more than 776,000 Medicare beneficiaries paid monthly penalties in 2020, increasing Medicare premiums by an average of 27%. As your question implies, that’s a fairly small share of Medicare’s approximately 64 million enrollees. But the number (three quarters of a million) is equivalent to the combined populations of Salem, Eugene, Hillsboro, Bend, Gresham and Medford.
Although some Medicare beneficiaries incur these penalties through inattention or carelessness, others pay monthly penalties because they didn’t understand Medicare’s rules. A bipartisan bill that passed the House of Representatives in 2020, and is now in the Senate, would deliver clear Medicare information to people approaching their 65th birthday. Forbes magazine reported on this bill, called the Beneficiary Enrollment Notification and Eligibility Simplification Act, as early as 2017.
Jim Sellers of Salem is a certified Medicare counselor with the Senior Health Insurance Benefits Assistance (SHIBA) 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.
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