The Golden Rule of Medicare Part B You NEED to Know
Dear Toni:
I have decided to retire when I turn 65 in September and will need to enroll in Medicare Parts A and B with a Medicare Supplement and Part D prescription drug plan.
My husband Tom is 67, and he enrolled in Medicare Parts A and B when he turned 65 because he has a heart condition. Tom remained on my company benefits when he had heart surgery.
Now, he is taking Eliquis for blood clots, and he needs to apply for a Medicare Supplement because his cardiologist’s office manager expressed concern over my husband’s insurance changes, since their office is accepting very few Medicare Advantage plans. He suggested that he enrolls in a Medicare Supplement.
Please explain what I need to do to get Medicare Supplement coverage for both me and my husband. We need your help.
Thanks,
Pat from St. Petersburg, FL
Pat,
Medicare Part B is as valuable as gold, and Americans should treat it accordingly. When you enroll in Part B the wrong way, it can disqualify you for the Medicare Supplement you desire. Medicare provides special rules for employees or spouses who are still working with “true” company benefits.
Pat, you are in your Medigap Open Enrollment Period. The “2023 Medicare & You” handbook has something to say about this. It states the following: “The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period.” During that time, you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the first month you have Medicare Part B (Medical Insurance), and you’re 65 or older. After this enrollment period, you may not be able to buy a Medigap policy. If you’re able to buy one, it may cost more due to past or present health problems.”
Your husband, Tom, is not under the same Medicare rule as you are. This is because he enrolled in Medicare Part B when he turned 65 over 2 years ago. Now, he must answer underwriting questions to qualify for a Medicare Supplement.
Read Next: Here’s How Working Past 65 Can Affect Your Medicare Enrollment
It is important to enroll in Part B when an enrollee or spouse is working full-time with true company benefits. First, you will avoid receiving a Medicare Part B penalty. Second, you will also want to be able to enroll in any Medicare Supplement (Medigap) due to medical underwriting.
If he cannot pass underwriting, Tom’s saving grace is that Pat is leaving her company benefits. Since Tom was covered under those benefits, he’ll receive a 63-day “guaranteed issue” period to apply for a Medicare Supplement. Keep the company benefit termination letter to show the insurance company that Tom is in a Guaranteed Issue period.
The Guaranteed Issue Period
According to your rights under the Guaranteed Issue Period, an insurance company must:
- Sell you a Medigap/Medicare Supplement policy. You retain the right to buy a Medigap plan A, B, C, F, K or L that any insurance company sells in your state.
- Cover all your pre-existing health conditions.
- Cannot charge you more for a Medigap/Medicare Supplement policy, regardless of past or present health problems.
Not many people realize the value to first receiving Medicare Part B until they’re in Tom’s situation. They want to apply for a Medicare Supplement and may not qualify, because they are no longer in their Medicare Open Enrollment period.
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Originally published February 02, 2023
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