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MEDICARE AHEAD

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BIKING WITH E-ASE

BIKING WITH E-ASE

Longtime Northern Michigan

local Elizabeth Edwards wears multiple hats: editor by day, wine bar owner by night. Life is way too much fun to hang up either and stop working, but as she nears 65 she wants to better understand her Medicare options. So, she turned to Andi Dolan, independent insurance specialist and founder of Traverse Benefits to help her navigate the Medicare maze.

by ELIZABETH EDWARDS AND ANDI DOLAN

ELIZABETH EDWARDS: Can you outline the parts and pieces in play?

ANDI DOLAN: The main terms you’ll hear are Parts A, B and D.

Part A: Hospital and hospice insurance you have been pre-paying via payroll taxes your entire working career.

Part B: Medical insurance (medically necessary and preventive care) you will be required to purchase if you do not have employer-based coverage. You’ll have higher premiums if you had elevated income two years prior to enrollment.

Part D: Drug coverage you are required to purchase in order to avoid penalty.

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MODERN DESIGN. MADE FOR THE WAY YOU LIVE.

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EE: I’ve been getting all kinds of information…

AD: You’ve been targeted. Six months before turning 65, your demographic data might be attached to a report known as T65. This allows insurance companies of various sizes to seek and find prospects so they may “sell” you Advantage or Supplemental Plans to augment original Medicare (Parts A, B, D).

Seek guidance early from your trusted professional circle. There are many moving parts and pieces to your personal Medicare equation. Talking often with knowledgeable local experts may optimize your planning (and comfort).

20 W-2 employees, your group policy pays first and Medicare becomes secondary.

Most (but not all) active employees who remain attached to group offerings enroll in only Part A, which could lower your group deductible exposures should hospitalization claims occur (yet primacy matters). Working beyond 65 years of age is a common occurrence. Get educated so you may understand how each of these parts fits your unique situation and the decisions that come with it.

2. You can delay your Part B and D enrollment if your medically necessary services and creditable prescription coverages are currently provided through your employer-based program. While enrolled in an employer-sponsored health care plan, you are in a protected class (which means late Medicare enrollment penalties will not occur). When you do decide to leave your group policy, you will need to align your Part B and D enrollment and decide which “strategy” will augment original Medicare.

3. The type of plan you are offered through your employer matters. Health Savings Accounts and Medicare do collide. If you are enrolled in a Health Savings plan and enrolled in original Medicare Parts A, B, D (one or a combo of any) your tax favored contributions are no longer valid. Your tax professional should be your first call for advice and guidance.

EE: I love my job and plan to work beyond age 65, like a lot of my friends. What do I need to consider?

AD: You should know there is interplay between employer-based coverage and original Medicare (Parts A, B, D). A few other things to know:

1. The size of your employer matters. For smaller organizations with fewer than 20 W-2 employees, Medicare can become the primary payer when coordinating your care with employer-based coverage. Larger employers with more than

EE: Where do I go to enroll in Medicare? AD: Oddly enough, beginning your initial enrollment into original Medicare (Parts A, B) starts at the Social Security Administration. Website access, SSA.gov, has just gotten easier, with a redesigned website for 2023. You can start this process as early as three months before your 65th birthday.

Andi Dolan is owner of Traverse Benefits, a local independent insurance agency advocating and providing health, life and disability solutions for employers, individuals and Medicare beneficiaries across Northern Michigan. traversebenefits.com

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