When to start Medicare coverage
If you are getting close to your 65th birthday, you are probably wondering when to start Medicare coverage. The start date for your Medicare coverage is based on when you sign up and which election period you’re in.
If you already receive Social Security benefits, there is no need to apply for for Medicare Part A or Part B. You are enrolled in both A and B automatically. Because you will pay a premium for Part B coverage, you can turn down Part B coverage.
Please Note: If you are a resident of either Puerto Rico or a foreign country, you do not get Part B automatically. You must sign up for it.
How soon can I sign up; Initial Enrollment Period:
Generally, when you turn 65. This is called your Initial Enrollment Period or IEP. Your IEP lasts for 7 months. It starts 3 months before you turn 65, and ends 3 months after the month you turn 65.
If your birthday is the first day of the month (ex. May 1st), your initial enrollment period will begin earlier than most people. Your enrollment period begins 4 months before you turn 65 and ends 2 months after you turn 65.
When to Start Medicare coverage; There are a few different ways to sign up for Medicare:
- Probably the easiest method is to sign up online. Once you create a my Social Security account, you can move forward and sign up for both Medicare A & B benefits. Important: be sure the website you are using to sign up has a URL ending in .gov. This way you can be sure you are on an official government website and your personal information is safe.
- You can call Social Security at 1-800-772-1213, TTY users call 1-800-325-0778.
- Apply in-person at your local Social Security office. Click here to locate an office near you.
- If either yourself or your spouse worked for the railroad, you can contact the Railroad Retirement Board by calling 1-877-772-5772.you sign up for Medicare, you can also apply for Social Security benefits at the same time if you want.
Note: If you would like, you can also sign up for Social Security benefits while you are signing up for Medicare A & B.
Click here for more information on when to sign up for Medicare
Although many people are not able to enroll in Medicare until they are close to their 65th birthday, some people qualify to enroll in Medicare due to a qualifying disability. Once an individual has received disability benefits for 24 months, or has been diagnosed with a qualifying medical condition, such as ALS ( Lou Gehrig’s disease) or end-stage renal disease (ESRD).
When to start Medicare coverage; One more thing:
Once you are eligible for Medicare if you neglect to sign up, you’ll have to wait until the general enrollment period to enroll. Each year, the general enrollment period runs from January 1 until March 31. Once you apply, your plan will start the first day of the following month. Please keep in mind, you may have to pay a late enrollment penalty if you do not enroll in Medicare during either your initial election period or a special election period.
Find out what Medicare covers
If you would like more information on Medicare enrollment, you can find it at Medicare.gov.
Connecticut Medicare AEP kickoff
This year, Pinnacle Financial Services will start the 2023 AEP with an exciting event; the Connecticut Medicare AEP kickoff. This event will take place on Friday, September 8th, 2023 at the Mohegan Sun Convention Center. The convention center is located at: 1 Mohegan Sun Blvd, Uncasville, CT 06328 and promises to be a great time for all who attend!
The festivities start at 10:00 am and run until 5:00 pm.
Be sure you save the date as there will be too much to miss.
Meet the carrier reps from all the top plans in CT. Learn what each carrier has to offer and find out how your clients can benefit from the added plans as well as plan upgrades.
Learn how to get your blog posts seen. This is a great tool to help you grow your business.
Find out about the NABIP updates.
We will discuss the changes in legislation that can effect your clients as well as the way you do business.
There will be much more to learn at this event, make sure you reserve your spot!
Click here to register for the AEP kickoff!
Let us help you make this your best year yet:
This is a great opportunity to get to know other professionals in the industry as well as put a face to the carrier reps we all like to call for help from time to time.
Get new ideas that could really jump start your 2024.
Pinnacle is providing all attendees with free food and beverages. There will be three meeting times; breakfast, lunch and happy hour. If you like, make it a weekend and stay over in one of the fabulous hotel rooms. Be sure to click the link below for the special discounted rate:
Click here for discounted room rate, use code (PINN23)
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Medicaid Redetermination 2023
As of April 1, 2023, Medicaid redetermination 2023 will start on a state level. The “Families First Corona Virus Response Act” established that anyone on Medicaid can not be re-certified every year. The Consolidated Appropriations Act of 2022 puts a firm end date to guaranteed continuous coverage as of April 1. There are an estimated 92 million people on Medicaid. Over 20 million have started Medicaid benefits in the last 2 years.
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Why is Medicaid Redetermination 2023 needed?
During the Coronavirus Pandemic the Families First Act put a moratorium on the states ability to recertify those on Medicaid. Many people lost their jobs during the pandemic. As a result of income loss, a large number of people applied for Medicaid. Under normal circumstances, the states would re-certify those on Medicaid every year. However, due to the Families First Act, a certification process was not enabled to check the qualifications of recipients on an annual basis. Many people who were able to find new jobs would have been taken off Medicaid due to the increase in income when they had to recertify. Because of this fact, an estimated 14 million people are currently receiving Medicaid benefits although they do not qualify based on income.
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The Consolidated Appropriations Act of 2022
For Medicare redetermination 2023 the CAA allows states to recertify those on Medicaid beginning April 1, 2023. Most states will not be able to immediately check everyone’s eligibility. Instead, many will start the normal annual certification process that was in place prior to the Families First Act stopping the process. However, there is a monetary incentive for states to move more quickly with this process. The enhanced federal funding rate of 5% ends in June of 2023. (It went from an extra 6.2% down to 5% in April of 2023) This means states will receive 5% less from the federal government toward the cost of those who receive Medicaid. In addition to the estimated 14 million that may no longer qualify, it is estimated another 6 million may lose coverage due to administrative churning. This refers to the possibility of administrative errors in the redetermination process for Medicaid Redetermination 2023.
Recertification process
The process for Medicaid Redetermination 2023 will not be a manual process for everyone. People with the lowest incomes as well as those who are disabled, can be passively renewed. This means they will not need to return any paperwork and will automatically keep Medicaid benefits. Those that are not passively renewed will receive recertification paperwork in the mail that must be completed and returned. If someone has moved without notifying the state, they may never receive that paperwork.
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QMB Program CT
The QMB Program CT is an essential program available to Medicare beneficiaries who meet the income requirements and reside in Connecticut. The QMB program provides the highest level of financial help to those who qualify. It assures that beneficiaries can receive the medical care they need.
In some instances, Medicare beneficiaries may face significant out-of-pocket costs for their healthcare services. When this occurs, the Medicare Qualified Medicare Beneficiary (QMB) program provides much needed assistance.
What is the Medicare QMB program:
The Medicare QMB program is a state-administered program that helps Medicare beneficiaries who have a limited income pay for things such as; Medicare premiums, deductibles, coinsurance, and copayments. QMB stands for “Qualified Medicare Beneficiary,” this refers to people who meet certain income and asset criteria.
How do you qualify for the Medicare QMB program:
A person must be enrolled in Medicare Part A and Part B and have limited income and resources. In 2023, the income limit for QMB eligibility in Connecticut is $2,564 per month for individuals and $3,468 per month for married couples. There is no asset limit to qualify for this program.
The Medicare QMB program in Connecticut covers the following:
- Medicare Part A premiums: Part A includes coverage for; inpatient hospital stays, skilled nursing facility care, hospice care, and home health care. The QMB program covers the monthly premium for Part A if either you or a spouse has not worked enough quarters to qualify for free Medicare Part A.
- Medicare Part B premiums: This portion of Medicare covers doctor visits, outpatient care, preventive services, and medical equipment.
- Deductibles, coinsurance, and copayments for covered services.
- Medicare Advantage premiums: The QMB program covers the monthly premium for Medicare Advantage plans.
- Part D prescription drug costs are covered by the QMB program.
There are 3 different levels of extra help available in CT:
As you will see, all three levels of MSP pay for the Medicare Part B premium.
- QMB is the highest level of help in CT. If your monthly income is either at or below $2,564 (single) or $3,468 (couple), you may qualify for this level of extra help. QMB program covers; Part B premium, Medicare deductibles as well as co-insurance.
- SLMB is the next level of extra help in CT. You may qualify for this level of help if your monthly income is either at or below $2,807 (single) or $3,797 (couple). This level of help pays for your Part B premium only.
- ALMB is the last level of extra help available to CT Medicare residents. To qualify for this level of help, your monthly income must be either at or below $2,989 (single) or $4,043 (couple). This program pays for your Part B premium only and is subject to available funding. People who receive Medicaid are not eligible for this program.
When you are accepted into any of the three levels of MSP, you are automatically enrolled into the LIS (Low Income Subsidy).
This program is also called “Extra Help”. LIS pays the cost of a Medicare Part D (prescription coverage) benchmark plan, or part of a non-benchmark plan. LIS also pays your Part D annual deductible, co-insurance, or co-pays on your prescription medications. This applies even if you reach the coverage gap. Another benefit if LIS enrollment is, you are allowed a Special election period to change your MA or Part D plan anytime during the first 3 quarters of the year
To sum it up; the QMB program CT is a valuable resource for those who qualify and are struggling to pay their Medical costs.
How to apply for the Medicare QMB or MSP help in Connecticut?
You can apply for the Medicare QMB program in Connecticut by contacting either the State of Connecticut Department of Social Services (DSS) or the Medicare Savings Programs (MSP) unit. There are a few ways to apply; online, by mail, or in person.
To apply online, visit the DSS website and complete an application. To apply by mail, just download an application from the DSS website. You can schedule an in-person meeting by calling the MSP unit 1-800-842-1508. Important: you must provide documentation of your income and assets, as well as your Medicare information.
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Medicare Enrollment Periods 2023
CMS regulates when beneficiaries can change Medicare Advantage and PDP plans. This article addresses Medicare enrollment, not MAPD/PDP enrollment.
General Enrollment Period
The General Enrollment Period (GEP) runs from January 1 through March 31. Coverage begins the first of the following month for beneficiaries enrolling in Medicare during the GEP. In previous years, coverage did not begin until July 1.
Initial Enrollment Period
The Initial Enrollment Period (IEP) is the seven-month period. Medicare beneficiaries can enroll 3 months prior and up to 3 months after their 65th birthday month. IEP includes three months before, the month of, and three months after someone’s 65th birthday month. Prior to 2023, people who enrolled in Medicare during the last three months of their IEP had to wait up to three months for coverage to begin. That is no longer the case. Coverage is effective the first of the month after the month of enrollment.
Special Medicare Enrollment Periods 2023
CMS established Special Enrollment Periods (SEPs) for Part B and premium Part A for those with an exceptional circumstance. SEP allows expand Medicare enrollment opportunities, reduce gaps in coverage, and prevent late enrollment penalties.
ISEP – New to Part B
This election period applies to beneficiaries new to Part B. Side note: a MAPD/PDD application must be submitted prior to the Part B effective date in order to use the ISEP.
SEP – Emergency or Disaster
This special election period offers beneficiaries that missed an enrollment opportunity due to a government declared an emergency. FEMA disasters are an example. Click here for additional disaster SEP information.
SEP for Loss of Coverage
An individual can use this SEP if their employer, employer plan, or someone acting on behalf of their employer gave them incorrect information that caused them to delay Medicare enrollment. In addition, this SEP applies when an individual loses group coverage. CMS allows a full 2 months for enrollment after the loss of creditable coverage.
SEP for Formerly Incarcerated Individuals
This SEP is for individuals who are released from incarceration on or after January 1, 2023. Formerly incarcerated people may be eligible for a Special Enrollment Period to enroll in Premium Part A and Part B. They won’t have to pay a late enrollment penalty if they enroll using the SEP.
Coverage start date is the first day of the month following the month of enrollment. Alternately, retroactive coverage can be requested up to 6 months in the past. Note: retroactive premiums apply.
SEP to Coordinate with Termination of Medicaid Coverage
This SEP, also called the Medicaid SEP, is for people who lose Medicaid eligibility. CMS allows a change for 3 months from either the day of ineligibility or notification, whichever is longer.
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Medicare inflation reduction act
Medicare inflation reduction act – Improvements to Medicare Part D:
Moving forward, people on Medicare will benefit from lower prescription drug costs as well as a redesigned prescription drug program. Updated benefits include:
- Insulin will be available at $35 per month, as long as it is on Medicare’s list of approved insulin prescriptions. This program does not apply to the very expensive insulin type drugs like Toujeo, Tresiba, Victoza, Januvia or Ozempic..
- Beneficiaries can access recommended adult vaccines without cost-sharing, such as Shingrix.
- Starting in 2025, the out-of-pocket costs of prescription drugs for Medicare plan members will have an annual cap of $2,000.
- The low-income subsidy program (LIS or “Extra Help”) under Medicare Part D will be expanded to 150% of the federal poverty level starting in 2024.
Medicare Drug Price Negotiation:
Medicare will be able to negotiate directly with drug manufacturers to lower the price of some prescription Medications. This applies to many of the most expensive, single-source, brand-name Medicare Part B and Part D drugs. In other words, people on Medicare will have more access to both innovative & life-saving treatments as the costs of these prescription drugs will be more affordable to them as well as to Medicare.
Inflation Rebates:
The new law will require any drug company that raises their drug prices faster than the rate of inflation to pay Medicare a rebate. This law will protect Medicare beneficiaries from unreasonable drug price increases put in place by the drug companies. This will ensure that both current and future Medicare enrollees are protected by a strong Medicare system.
Medicare inflation reduction act – Medicare Part B changes:
Changes in the Medicare Part B program will improve access to high quality, affordable biosimilars for people with Medicare as well as impose a $35 a month cost-sharing cap on insulin used in durable medical equipment pumps.
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What part of Medicare covers hospice
If you are going through a difficult time with a loved one, you may ask; what part of Medicare covers hospice.
First let us explain what hospice is:
Hospice care provides support and comfort to patients who have a terminal illness and have decided to focus on improving the quality of their remaining life rather than seeking curative treatment. Medicare covers hospice care for all eligible beneficiaries. In the next few paragraphs, we’ll take a closer look at how Medicare covers hospice care.
Who is eligible for Medicare hospice coverage?
To be eligible for Medicare hospice coverage, a patient must meet the following criteria:
- The patient must be eligible for Medicare Part A (hospital insurance).
- The patient must be diagnosed with a terminal illness and have a life expectancy of six months or less.
- The patient must choose hospice care instead of curative treatment for their terminal illness.
What services does Medicare hospice cover?
Once a patient is deemed eligible for Medicare hospice coverage, they are entitled to receive a range of services related to their terminal illness. These services may include:
- Medical care: This includes visits from a hospice doctor, nursing care, medication management, medical equipment and supplies.
- Support services: Hospice care providers may offer counseling and emotional support to patients as well as their families.
- Respite care: In some cases, a patient’s caregiver may need a break from providing care. Hospice care providers can offer short-term respite care to relieve the caregiver’s burden.
- Bereavement services: Hospice care providers may offer bereavement counseling and support to family members after the patient has passed away.
- Spiritual and religious services: Hospice care providers may offer spiritual and religious support to patients and their families.
How much does Medicare hospice coverage cost?
For most Medicare beneficiaries, Medicare coves 100% of the hospice care cost. This means, the patient does not have to pay out-of-pocket for hospice care. However, patients who receive care from a hospice provider that is not Medicare-certified may end up will a bill for some of the costs.
Please note; while hospice care is covered 100% by Medicare, other services that a patient may receive while in hospice care, such as treatment for an unrelated illness, may or may not be covered by Medicare.
In conclusion, Medicare covers hospice care for eligible beneficiaries, including medical care, support services, respite care, bereavement services, and spiritual and religious services. Medicare typically covers 100% of hospice care cost, but it’s important for patients to choose a Medicare-certified hospice provider to avoid any unexpected costs. Hospice care can provide comfort and support to patients with terminal illnesses and their families during a difficult time.
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Medicare supplement sales
Although Medicare covers many medical expenses for qualified individuals, it doesn’t cover everything. That is why many health care agents go into Medicare supplement sales. Medicare supplement plans, also known as Medigap plans, help fill the gaps in Medicare coverage.
If you want to offer Medicare supplement plans to your clients, there are several things you should know:
First, it’s important to understand the basics of Medicare as well as the different types of Medicare supplement plans.
This information will help clients choose the plan that best meets their needs. You may have to ask questions about your client’s health, budget, and preferred providers, as well as explaining the plan differences.
There are four parts to Medicare: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). Medicare supplement plans are designed to work with Parts A and B. There are 10 standardized Medigap plans available in most states.
There 10 Medigap plans available in most states are; A, B, C, D, F, G, K, L, M, and N.
Each plan has its own set of benefits, so it’s important to understand what each plan covers and how it works with Medicare. Here are some of the key differences between the plans:
- Plan F: This plan provides the most comprehensive coverage, covering all of the benefits listed above. However, it is no longer available to new enrollees as of 2020.
- Plan G: This plan is similar to Plan F, but it does not cover the Part B deductible. It has become a popular alternative to Plan F since it provides similar coverage at a lower cost.
- Plan N: This plan has lower premiums than Plans F and G, but it requires some cost-sharing. This includes copays for doctor visits and emergency room visits.
Please note; Medigap plans are standardized. This means that each plan must offer the same benefits, regardless of which insurance company is offering the plan.
Because supplement plans have their own benefits, it’s important to understand what each plan covers and how it works with Medicare. For example, some Medigap plans may cover deductibles, copayments, and coinsurance, while others may provide coverage for foreign travel emergency care or skilled nursing facility care.
In addition, it’s important to be aware of the rules and regulations surrounding Medicare supplement sales.
For example, there are strict guidelines around marketing and advertising, and it’s important to follow these guidelines to avoid any legal issues.
It is extremely important to build relationships with clients and provide any assistance you are qualified to offer. This may include answering questions about Medicare and Medigap plan coverage and plan enrollment.
In conclusion, selling Medicare supplement plans can be a rewarding career path for salespeople who are passionate about helping others. By understanding the basics of Medicare, the different types of Medigap plans, and the rules and regulations surrounding Medicare supplement sales, salespeople can help clients make informed decisions and provide ongoing support and assistance.
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What will Medicare pay for
Because many people are unsure what will Medicare pay for, we are providing a quick summary of the parts of Medicare and what they cover.
Medicare is a federal health insurance program. It provides coverage to people who are either 65 years or older, people with disabilities, and those with end-stage renal disease. There are four parts of Medicare plans: Part A, Part B and Part C, as well as Part D.
What Medicare Part A pays for:
Part A or hospital insurance covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.
- Inpatient Hospital Stays: Part A pays for the cost of a semi-private room, meals, nursing care, and other hospital services and supplies. It also covers the cost of surgeries, anesthesia, and other medically necessary procedures.
- Skilled Nursing Facility Care: If you need to stay in a skilled nursing facility for a short period after being discharged from the hospital, Part A covers the cost of a semi-private room, meals, nursing care, and therapy.
- Hospice Care: If you have a terminal illness, Part A covers hospice care services, including pain relief, counseling, and medical care.
- Home Health Care: Part A covers some home health care services if you are homebound and need skilled nursing care, physical therapy, or speech-language pathology services.
What Medicare Part B pays for:
Part B is also called medical insurance. It covers medically necessary services and preventive services that are not covered by Part A. Here’s what Part B pays for:
- Doctor’s Services: This includes office visits, consultations, and surgical procedures.
- Outpatient Services: Part B covers services that include diagnostic tests, laboratory services, and imaging tests.
- Preventive Services: These services include flu shots, cancer screenings, and annual wellness visits.
- Durable Medical Equipment: Beneficiaries receive coverage for the purchase of durable medical equipment, including wheelchairs, walkers, and oxygen equipment.
- Ambulance Services are covered if they are medically necessary.
What Medicare Part C pays for:
Medicare Part C or Medicare Advantage (MA plans). It is an alternative to Original Medicare, which includes Part A and Part B. Medicare Advantage plans are offered by private insurance companies. In most cases, they include additional benefits, such as vision, dental, and hearing coverage. Medicare Advantage plans must cover all the services that Original Medicare covers, but the cost-sharing and rules may be different.
What Medicare Part D pays for:
Some people refer to these plans as prescription drug coverage. Private insurance companies offer this coverage to cover the cost of prescription drugs. Part D plans typically have a formulary, which is a list of drugs that the plan covers. The cost-sharing and rules for Part D plans may vary.
In conclusion, Medicare covers a wide range of medical services. This includes hospital stays, doctor’s visits, preventive care, medical equipment, and prescription drugs. Understanding what each part of Medicare covers can help you make informed decisions about your healthcare needs.
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Medicare Advantage sales
Medicare Advantage Sales: A Guide for Insurance Agents
Medicare Advantage plans, also known as Medicare Part C, are becoming a very popular choice for many Medicare beneficiaries. Because of this fact, many Medicare agents earn a good portion of their commission through the sale of MA plans. These plans are an alternative option to the Original Medicare plans that Medicare offers. In this blog, we go over a few things you need to know about the sale of MA plans.
Understanding Medicare Advantage Plans
Before we dive into Medicare Advantage sales, it is important to understand what these plans are. Medicare Advantage plans provide benefits similar to Original Medicare (Part A & Part B). Original Medicare does not offer these plans. Only private insurance companies can offer these plans to beneficiaries. Most plans include additional benefits such as vision, dental and hearing coverage. Many MA plans also provide prescription drug coverage (Part D).
These plans typically have either a low or no plan premium. It is important to note; MA plans have restrictions on which doctors and hospitals you can use. In addition, beneficiaries must continue to pay their Part B premium even while enrolled in a Medicare Advantage plan.
Eligibility for MA Plans
To be eligible for a Medicare Advantage plan, individuals must be enrolled in both Medicare Part A and Part B, and live within the plan’s service area. There are several instances when enrollment in these plans typically occurs. They can enroll during their Initial election period (IEP) or during the Annual Enrollment Period (AEP) which takes place from October 15th through December 7th each year. However, individuals may also be able to enroll in a Medicare Advantage plan during certain special enrollment periods (SEPs).
Selling Medicare Advantage Plans
Now that you understand what Medicare Advantage plans are and who is eligible for them, let’s discuss how to sell these plans as an insurance agent.
- Obtain the necessary licenses and certifications: In order to sell Medicare Advantage plans, you must be licensed as an insurance agent and certified to sell Medicare Advantage plans by both the insurance carrier and Centers for Medicare and Medicaid Services (CMS).
- Know your products: It’s important to understand the various Medicare Advantage plans offered by different insurance companies, as well as the benefits, costs, and restrictions associated with each plan. This knowledge will allow you to help clients choose the best plan for their needs.
- Develop a marketing strategy: Medicare Advantage sales require a targeted marketing strategy. You may want to consider advertising in local newspapers or on social media, attending community events, and offering educational seminars.
- Build relationships with clients: As with any sales business, building relationships with clients is key to success. Make sure to follow up with clients after they enroll in a plan to ensure they are satisfied with their coverage and answer any questions they may have.
- Stay up-to-date with changes: Medicare Advantage plans can change from year to year, so it’s important to stay informed of any updates or changes to the plans you offer. This will ensure that you can provide accurate and up-to-date information to your clients.
2023 MA commissions
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In conclusion, selling Medicare Advantage plans can be a rewarding business opportunity for insurance agents. By obtaining the necessary licenses and certifications, knowing your products, developing a marketing strategy, building relationships with clients, and staying up-to-date with changes, you can successfully sell these plans to Medicare beneficiaries.
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AHIP certification cost
New Medicare agents have many questions when they are just starting out. One thing they may ask about is the AHIP certification cost.
Medicare Advantage plans are becoming more and more popular with Medicare beneficiaries. That makes it more important than ever for Medicare agents to take the annual AHIP exam in order to be certified to sell either Medicare Advantage or prescription drug plans.
First, let’s review what the Medicare AHIP certification is:
AHIP stands for America’s Health Insurance Plans, which is an industry organization that works with Medicare to provide training and certification for agents who sell Medicare Advantage plans. The AHIP certification is required for agents who wish to sell Medicare Advantage plans or prescription drug plans. The AHIP program covers a range of Medicare topics that include; eligibility, benefits, and enrollment.
Find out more about AHIP
How much does the Medicare AHIP certification cost:
Currently, the cost of the AHIP certification is $175 per year. However, this cost may be reduced if the agent is affiliated with a Medicare Advantage plan or if they have a discount code. Some insurance companies may either pay for the certification or reimburse their agents for the cost of the certification.
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In addition to the AHIP certification, agents must also complete carrier-specific training:
In order to sell Medicare Advantage plans, agents must complete carrier-specific training in order to be ready to sell each year. Some insurance companies may require agents to complete in-person training to maintain their certification.
It’s important to note; the cost of the Medicare AHIP certification is just one of the costs associated with selling Medicare Advantage plans. Agents must also pay for their own marketing materials, travel expenses, and other business-related costs. They also have to pay for errors and omissions insurance. This is important to protect them in the event of a lawsuit or other legal action.
In conclusion, the cost of the Medicare AHIP certification is generally $175 per year. Agents also incur many other expenses during the course of doing business. Any time agents can save money, it is helpful. It’s important for agents to factor in these costs, as well as other business-related expenses, when deciding whether to sell Medicare plans. Ultimately, the potential earnings from selling Medicare plans should far outweigh the costs of certifications and other expenses for agents who are successful in this field.
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Delaying Medicare Part B
Medicare is a federal health insurance program that provides coverage for people over the age of 65, as well as those with certain disabilities or conditions. Medicare Part A is automatically provided to most individuals. Enrollment in Part B is optional and comes with a monthly premium.
For many individuals, Medicare Part B enrollment is a straightforward process that occurs during their initial enrollment period. The IEP begins three months before their 65th birthday and ends three months after it. However, some people delay their enrollment in Part B, either due to a lack of knowledge about the program or because they have other insurance available to them.
While delaying enrollment in Part B may seem like a good idea for some, it can have significant consequences down the line. We will explore the risks and costs associated with delayed Medicare Part B enrollment, as well as some tips for avoiding these issues.
Risks of Delayed Enrollment
One of the biggest risks of delaying enrollment in Medicare Part B is the potential for a late enrollment penalty. If you do not enroll in Part B during your initial enrollment period and do not have other creditable coverage, you may be subject to a penalty of 10% for each 12-month period that you could have had Part B but didn’t enroll. This penalty is added to your monthly premium for as long as you have Part B coverage.
Another risk of delayed enrollment is that you may be subject to a gap in coverage. If you are relying on another form of insurance, such as an employer-sponsored plan, to provide your healthcare coverage, you may not realize that this coverage will end once you retire or otherwise become ineligible. If you do not enroll in Part B during your initial enrollment period, you may not have the coverage you need. You may have to wait until the next open enrollment period, which could be several months away.
Costs of Delayed Enrollment
In addition to the late enrollment penalty, delayed enrollment in Medicare Part B can also result in higher out-of-pocket costs. This is because Medicare may not cover certain services or treatments that would have been covered if you had enrolled in Part B earlier. For example, if you delay your enrollment in Part B and then require chemotherapy treatment, you may be responsible for a larger share of the costs than you would have been if you had enrolled in Part B earlier.
Tips for Avoiding Delayed Enrollment
The best way to avoid the risks and costs associated with delayed enrollment in Medicare Part B is to enroll during your initial enrollment period. You can enroll in Part B either online, by phone, or in person at your local Social Security office.
If you have other forms of insurance, such as an employer-sponsored plan, it’s important to understand how this coverage will interact with Medicare. In many cases, you may be required to enroll in Medicare Part B once you retire or otherwise become ineligible for your current coverage. To avoid any gaps in coverage or late enrollment penalties, be sure to speak with your employer’s benefits administrator or a Medicare representative to understand your options and obligations.
In summary, delaying enrollment in Medicare Part B can have significant consequences, including late enrollment penalties and higher out-of-pocket costs. To avoid these issues, it’s best to enroll during your initial enrollment period and to understand how your other forms of insurance will interact with Medicare. By taking these steps, you can ensure that you have access to the healthcare coverage you need, when you need it.
There are changes in Part B enrollment starting in 2023
What is changing:
As of January 1, 2023, If you sign up for Medicare Part B during the last 3 months of your IEP, your coverage will start the first day of the month after you sign up. Before the change, anyone who signed up for Part B coverage during the last 3 months of their IEP would not be covered until 2 or 3 months after they enrolled.
If you don’t sign up for Medicare Part B during your IEP
You will be able to enroll during the General Enrollment Period (GEP). The GEP runs from January 1 through March 31 each year. Starting January 1, 2023, your coverage starts the first day of the month after you sign up.
Find out more about these updates on the official Medicare website.
Learn more about Medicare Part B Delayed enrollment